Middle Childhood 5 –10 Years MIDDLE CHILDHOOD • 5–10 YEARS MIDDLE CHILDHOOD

iddle childhood, ages 5 to 10, is meaning of competition and teamwork. They may characterized by a slow, steady rate lack the cognitive skills to grasp strategies, make of physical growth. However, cogni- rapid decisions, and visualize spatial relationships. tive, emotional, and social develop- Like the developmental milestones of infancy, Mment occur at a tremendous rate. To achieve such as rolling over, sitting up, crawling, and walk- optimal growth and development, children need to ing, most of the fundamental motor skills (e.g., run- eat a variety of healthy foods and participate in ning, galloping, jumping, hopping, skipping, physical activity. Physical activity can throwing, catching, striking, kicking) required for • Give children a feeling of accomplishment. physical activity are acquired in the same sequence. Motor skill acquisition appears to be an innate • Reduce the risk of certain diseases (e.g., coronary process, independent of the child’s sex, age, size, heart disease, hypertension, colon cancer, dia- weight, strength, abilities, and level of physical betes mellitus), if children continue to be active maturity. As with other developmental milestones, during adulthood. the rate at which children master motor skills varies • Promote mental health. considerably. As children grow and develop, their motor Although children can acquire and refine fun-

skills increase, giving them an opportunity to par- damental motor skills faster by early instruction YEARS MIDDLE CHILDHOOD • 5–10 ticipate in a variety of physical activities. Children and practice, they are unlikely to do so until they may try different physical activities and establish an are developmentally ready. Children usually acquire interest that serves as the foundation for lifelong fundamental motor skills at a basic level through participation in physical activity. play; however, children need instruction and prac- Children are motivated to participate in physi- tice to fully develop these skills.1 cal activity by fun, previous success, variety, family Each fundamental motor skill is characterized support, peer participation, and enthusiastic coach- by a series of developmental stages. Failure to ing. Feelings of failure, embarrassment, competi- achieve progression through all of the stages can tion, boredom, and rigid structure discourage limit proficiency in physical activities that require participation. Children usually discontinue physical fully developed fundamental motor skills. Transi- activity because of a lack of time, feelings of failure, tional motor skills are fundamental motor skills per- overemphasis on competition, or the existence of formed in various combinations and with variations overuse injuries (e.g., stress fracture, inflammation (e.g., throwing for distance; throwing for accuracy). of the joints). Transitional motor skills are required to participate Children in middle childhood are at various in entry-level organized sports. Early in this develop- stages of cognitive, emotional, social, and motor mental period, children’s vision is almost mature, skill development. They may not understand the but it is still difficult for them to tell the direction in

49 which a moving object is moving. Balance becomes During middle childhood, boys have more lean more automatic and reaction times become quicker. body mass per inch of height than girls. These dif- With improved transitional motor skills, children ferences in body composition become more signifi- are able to master complex motor skills (e.g., those cant during adolescence. required for playing more complex sports such as During middle childhood, children may football or basketball). At the end of this develop- become overly concerned about their physical mental period, children’s vision is fully mature.1 appearance. Girls especially may become concerned Motor skill development is difficult for some that they are overweight and may begin to eat less. children. Health professionals need to assess these Parents should reassure their daughters that an children to determine whether their difficulties are increase in body fat during middle childhood is part caused by a developmental delay or a health prob- of normal growth and development and is probably lem. In some cases, poor motor skill development is not permanent. Boys may become concerned about the result of developmental coordination disorder their stature and muscle size and strength. (DCD).2 (See the Developmental Coordination Dis- During middle childhood, children’s muscle order chapter.) strength, motor skills, and stamina increase. Chil- dren acquire the motor skills necessary to perform Growth and Physical complex movements, allowing them to participate in a variety of physical activities. Development For females, most physical growth is completed Middle childhood’s slow, steady growth occurs by 2 years after menarche. (The mean age of menar- until the onset of puberty, which occurs late in mid- che is 12 1/2 years.) Males begin puberty about 2 dle childhood or in early adolescence. Children gain years later than females. Before puberty, there are an average of 7 pounds in weight, and 2 1/2 inches in no significant differences between boys and girls in height, per year. They have growth spurts, which are height, weight, strength, endurance, and motor skill usually accompanied by an increase in appetite and development. Therefore, throughout middle child- food intake. Conversely, a child’s appetite and food hood, boys and girls can participate in physical intake decrease during periods of slower growth. activity on an equal basis. Late-maturing children, Body composition and body shape remain rela- who have a prolonged period of prepubertal tively constant during middle childhood. During growth, usually have longer limbs than other chil-

MIDDLE CHILDHOOD • 5–10 YEARS preadolescence and early adolescence (9 to 11 years dren and often attain greater height. in girls; 10 to 12 years in boys), the percentage of A temporary decline in coordination and bal- body fat increases in preparation for the growth ance may occur during puberty because of rapid spurt that occurs during adolescence. This body fat growth. Some children may be unable to perform a increase occurs earlier in girls than in boys, and the physical activity as well as they did the previous amount of increase is greater in girls. Preadoles- year. This can be frustrating for children, parents, cents, especially girls, may appear to be “chunky,” and teachers, particularly if they misinterpret this but this is part of normal growth and development. decline as a lack of skill or effort.

50 ing or eating disorders. In addition, the increase in body fat and decrease in muscle flex may result in less fluid movements during the growth spurt and may increase the risk of overuse injuries in girls. Girls entering puberty are at particularly high risk for dropping out of physical activities, making anticipatory guidance particularly important to encourage continued participation. Healthy Lifestyles Parents are a major influence on a child’s level of physical activity. By participating in physical activity (e.g., biking, hiking, playing basketball or baseball) with their children, parents emphasize the importance of regular physical activity and show their children that physical activity can be fun. Par- ents’ encouragement to be physically active signifi- cantly increases a child’s activity level.3 Children

are also influenced to participate in physical activity YEARS MIDDLE CHILDHOOD • 5–10 Early-maturing boys have a temporary physical by other family members, peers, teachers, and peo- advantage over other boys their age because they ple depicted in the media. are taller, heavier, and stronger. These boys usually Teachers also influence a child’s level of physi- achieve the most success in physical activity pro- cal activity. Physical education should be provided grams (e.g., hockey, football, basketball), which at school every day, and enjoyable activities should may lead to unrealistic expectations that they will be offered. continue to be outstanding athletes. Conversely, To achieve optimal growth and development, late-maturing boys have a temporary physical disad- children need a variety of healthy foods that pro- vantage. These boys may achieve the most success vide sufficient energy, protein, carbohydrates, fat, in physical activities in which size is not important minerals, and vitamins. They need three meals per (e.g., racquet sports, martial arts, running, wrest- day plus snacks. During middle childhood, meal- ling). times take on more social significance, and children For girls, the onset of puberty is associated with become affected by external influences (e.g., their an increase in body fat that may result in a decline peers, the media) regarding eating behaviors and in physical activity performance. Girls, parents, and attitudes toward food. Children also eat more meals teachers need to understand, and girls need to away from home (e.g., at child care facilities, accept, the physical changes of puberty, because school, homes of friends and relatives). Parents and attempts to prevent these changes can lead to diet- other family members continue to have the most

51 activity in children. However, there are many barriers. Some children do not have opportunities for participating in physical activity, and some live in unsafe neighborhoods. Communities need to provide physical activity programs through schools, recreation centers, and churches and other places of worship, and provide safe places for children to play. Strengths, and Issues and Concerns During health supervi- influence on children’s eating behaviors and atti- sion visits, health professionals should emphasize tudes toward food. Parents need to make sure that the physical activity strengths of the child, family, healthy foods are available, and they can be positive and community (Table 9) and address any physical role models by practicing healthy eating behaviors activity issues and concerns (Table 10). themselves. In addition, parents need to provide guidance to help children make healthy food choic- es away from home. Building Partnerships Partnerships among health professionals, fami- MIDDLE CHILDHOOD • 5–10 YEARS lies, and communities are essential for ensuring that families receive guidance on physical activity. Health professionals need to give families the opportunity to discuss physical activity issues and concerns, and need to identify and contact community resources to help parents promote physical

52 Table 9. Physical Activity Strengths During Middle Childhood

Child Family Community Participates in physical activity Encourages the child to partici- Promotes physical activity pate in physical activity Enjoys physical activity Provides programs that teach Provides opportunities for the families about physical and Develops a positive attitude child to participate in physical motor skill development toward physical activity activity Provides opportunities for chil- Is aware of and has opportuni- Supervises the child during dren to participate in physical ties to participate in physical physical activity activity activity Ensures that the child uses Maintains policies (e.g., preser- Wants to improve motor skills appropriate safety equipment vation of green space) and pro- Feels competent when partici- (e.g., helmet, wrist guards, vides environmental support pating in physical activity elbow and knee pads) during (e.g., well-maintained sidewalks, physical activity bicycle racks outside public facil- Is developing a sense of respon- ities) that promote physical Participates in physical activity sibility for own health activity with the child Has positive role models for Provides safe environments for physical activity Provides positive role model by indoor and outdoor physical YEARS MIDDLE CHILDHOOD • 5–10 participating in physical activity activity (e.g., walking and biking paths, playgrounds, parks, recreation centers) Provides support for families of children with special health care needs

53 Table 10. Physical Activity Issues and Concerns During Middle Childhood

Child Family Community Has health problems Does not encourage the child to Lacks programs that promote participate in physical activity physical activity in children Experiences motor skill or developmental delays Does not advocate for physical Lacks safe environments for education in schools indoor and outdoor physical Lacks opportunities to partici- activity (e.g., walking and bik- pate in physical activity Does not provide positive role ing paths, playgrounds, parks, model by participating in physi- Lacks friends or siblings to be recreation centers) cal activity physically active with Lacks policies (e.g., preservation Does not participate in physical Does not enjoy physical activity of green space) and does not activity with the child provide environmental support Does not feel competent when Has health problems that affect (e.g., well-maintained sidewalks, participating in physical activity the amount of time spent with bicycle racks outside public facil- Is embarrassed about appear- the child ities) that promote physical activity ance or lack of coordination Has a work schedule or other Is shy or fearful of physical commitments that reduce the Does not provide support for activity amount of time spent with the families of children with special child health care needs Has had unsuccessful or unpleasant experiences with Lacks space or equipment for physical activity physical activity Is more interested in sedentary behaviors (e.g., watching television and videotapes; playing computer games) MIDDLE CHILDHOOD • 5–10 YEARS

54 MIDDLE CHILDHOOD PHYSICAL ACTIVITY SUPERVISION

A child’s level of physical activity should be Health professionals can then use this chapter’s assessed as part of health supervision visits. (For screening and assessment guidelines, and counsel- more information on health supervision, see Bright ing guidelines, to provide families with anticipatory Futures: Guidelines for Health Supervision of Infants, guidance. Interview questions, screening and assess- Children, and Adolescents, listed under Suggested ment, and counseling should be used as appropriate Reading in this chapter.) and will vary from visit to visit, child to child, and Health professionals can begin by gathering family to family. information about the child’s level of physical Desired outcomes for the child, and the role of activity. This can be accomplished by selectively the family, are identified to assist health profession- asking key interview questions listed in this chap- als in promoting physical activity. ter, which provide a useful starting point for identi- fying physical activity issues and concerns. Interview Questions The following questions are intended to be used selectively to gather information, to address the family’s issues and concerns, and to build partnerships. MIDDLE CHILDHOOD • 5–10 YEARS MIDDLE CHILDHOOD • 5–10 For the Child Do you think physical activity is important? Why (or why not)? Do you think you are getting enough physical activity? Why (or why not)? Which physical activities do you participate in? How often? For how long each time? Do you participate in physical activities at school? If so, which ones? How often? Do you participate in physical activities in your neighborhood? If so, which ones? How often? Do you participate in any physical activities with your parents (for example, walking, biking, hiking, skating, swimming, or running)?

55 Are there any physical activities you enjoy but What does he do after school? Does he partici- don’t participate in? If so, which ones? Why? pate in physical activity? Are there any physical activities you don’t enjoy? Are there any physical activities that Susan If so, which ones? Why? enjoys but does not participate in? If so, which Do you feel that you are good at physical ones? Why? activities? If so, which ones? If not, why? Are there any physical activities that she doesn’t Do you think you are in good shape? Can you enjoy? If so, which ones? Why? keep up with your friends and other children During the past 6 months, has Thomas been your age? involved in physical activity programs? If so, Do you always have something available to drink which ones? during and after physical activity? During the past 6 months, has he trained for any Do you use appropriate safety equipment when physical activities? If so, which ones? you participate in physical activity? For Do you feel that Susan is too active? If so, why? example, do you use a helmet when you go Do you feel that she is not active enough? If so, skate-boarding, skating, or biking? why? Have you been injured while participating in Are there any physical activity programs in physical activity? Thomas’s school? In the community? If so, do How much time each day do you spend watching you think he would participate if encouraged? television and videotapes or playing computer How can you help him become more active? games? What barriers would make this difficult? Do you and Susan participate in physical For the Parent activities together? If so, which ones? How Is Thomas currently going through a growth often? spurt? How much time each day do you allow her to Do you have any concerns about his development? watch television and videotapes or play Do you have questions or concerns about Susan’s computer games? MIDDLE CHILDHOOD • 5–10 YEARS participation in physical activity? Do you know where to take Thomas in a medical Does she participate in regular physical activity emergency? (for example, most, if not all, days of the Is your neighborhood safe enough for him to week)? play outside? Does Thomas participate in physical education at school? If so, how often?

56 Screening and Assessment Some children have a high BMI because of a large, lean body mass resulting from physical If a child wants to participate in a sports pro- activity, high muscularity, or frame size. An ele- gram, a preparticipation physical examination may vated skinfold (i.e., above the 95th percentile on be useful. In addition to the screening and assess- CDC growth charts) can confirm excess body fat ment guidelines that follow, health professionals in children. can refer to resources such as a preparticipation physical evaluation.4 Assess the child’s general health status, including medical conditions and recent illnesses. Assess Obtain a complete medical history of the child, the child’s cardiovascular, pulmonary, and mus- including (1) history of previous injuries and hos- culoskeletal systems. Obtain the child’s blood pitalizations, (2) family history of sudden cardiac pressure. death, and (3) history of dizziness or fainting during or after physical activity.4 You may want Determine whether the child is taking any to inquire about conditions affecting sports par- medications. 5, 6 ticipation. Assess the child’s motor skill development Measure the child’s height and weight, and plot (Table 11). these on a standard growth chart (see Tool H: Assess the child’s physical maturity. CDC Growth Charts). Deviation from the expect- Assess the child’s level of physical activity by

ed growth pattern (e.g., a major change in YEARS MIDDLE CHILDHOOD • 5–10 growth percentiles on the chart) should be evalu- • Determining how much physical activity the ated. This may be normal or may indicate a child participates in on a weekly basis. problem (e.g., difficulties with eating). • If possible, evaluating how the child’s physical Height and weight measurements can be used to fitness compares to national standards (e.g., by indicate nutrition and growth status. Changes in reviewing the results of the child’s President’s weight reflect a child’s short-term nutrient intake Council on Physical Fitness and Sports test). and serve as general indicators of nutrition status and overall health. Low height-for-age may Counseling reflect long-term, cumulative nutrition or health problems. General Children should be physically active every day or Body mass index (BMI) can be used as a screening nearly every day, as part of play, games, physical tool to determine nutrition status and overall education, planned physical activities, recreation, health. Calculate the child’s BMI by dividing and sports, in the context of family, school, and weight by the square of height (kg/m2) or by community activities. referring to a BMI chart. Compare the BMI to the norms listed for the child’s sex and age on the Physical activity is recommended on most, if not chart. (See the Obesity chapter.) all, days of the week. Explain that children can

57 Table 11. Motor Skill Development During Middle Childhood

Age Motor Skills Being Appropriate Physical Activities Developed

5–6 Years • Fundamental (e.g., • Activities that focus on having fun and developing running, galloping, motor skills rather than on competition jumping, hopping, • Simple activities that require little instruction skipping, throwing, catching, striking, • Repetitive activities that do not require complex motor kicking) and cognitive skills (e.g., running, swimming, tumbling, throwing and catching a ball)

7–9 Years • Fundamental • Activities that focus on having fun and developing • Transitional (e.g., motor skills rather than on competition throwing for dis- • Activities with flexible rules tance; throwing for • Activities that require little instruction accuracy) • Activities that do not require complex motor and cognitive skills (e.g., entry-level baseball, soccer)

10–11 Years • Transitional • Activities that focus on having fun and developing • Complex (e.g., play- motor skills rather than on competition ing basketball) • Activities that require entry-level complex motor and cognitive skills • Activities that continue to emphasize motor skill development but that begin to incorporate instruction on strategy and teamwork

achieve this level of activity through moderate Encourage children to find physical activities physical activities (e.g., brisk walking for 30 min- they enjoy and can continue into adulthood.

MIDDLE CHILDHOOD • 5–10 YEARS utes) or through shorter, more intense activities Discuss with parents how children can incorpo- (e.g., skating or playing basketball for 15 to 20 rate physical activity into their daily lives (e.g., minutes). by using the stairs instead of taking the elevator It is critical for children to understand the impor- or escalator; by walking or riding a bike instead tance of physical activity. This may encourage of riding in a car). them to stay active during adolescence, when Many elementary schools include physical educa- their level of physical activity tends to decline. tion in their curricula. Schools that participate in

58 the President’s Council on Physical Fitness and sands of yards) is of limited value for future Sports program usually conduct testing when performance. children are in middle childhood. Encourage parents to take the results of their child’s fitness test Injury Prevention to the health professional to discuss positive results as well as suggestions for improvement. Encourage parents to make sure that children drink plenty of fluids when they are physically Encourage parents to participate in physical active. Before puberty, children are at increased activity with their children and to be positive risk for heat-related illness because their sweat role models by participating in physical activity glands are not fully developed and they cannot themselves. cool themselves as well as adolescents can. (See the Heat-Related Illness chapter.)

Physical Development Emphasize the importance of using appropriate Discuss physical development with children safety equipment (e.g., helmets, wrist guards, and their parents, and tell them the approximate elbow and knee pads) when participating in time they should expect accelerated growth. For physical activity. (See the Injury chapter.) girls, this may occur at ages 9 to 11, typically 1 to Inform parents and their children that the risk of 2 years before the onset of menarche; for boys, injury is higher during periods of rapid growth. this may not occur until about age 12 or older. For children interested in weight or strength YEARS MIDDLE CHILDHOOD • 5–10 Help girls entering puberty to understand and training, recommend doing several sets of multi- accept the physical changes of puberty that may ple repetitions and using weights that provide alter their appearance and physical activity low resistance. Emphasize the importance of performance. appropriate safety equipment and supervision by Explain to older children that some of their peers a qualified adult. Children should not participate may start puberty earlier than they do, reassuring in maximal weightlifting, powerlifting, or body- them that their development is normal. building until their growth and physical matura- tion are complete. Explain the growth chart to children and their parents and discuss how the children compare to Emphasize the importance of reducing children’s others their age. Emphasize that a healthy body exposure to sunlight while playing outdoors and weight is based on a genetically determined size thus their risk of developing skin cancer. Recom- and shape rather than on an ideal, socially mend that parents practice preventive strategies defined weight. such as (1) applying a broad-spectrum sunscreen with a sun protection factor (SPF) rating of 15 or Tell parents and their children that, before puber- greater to children’s exposed skin 30 minutes ty, cardiorespiratory conditioning such as inten- before they go outdoors, (2) reapplying sunscreen sive endurance training (e.g., swimming thou- every 2 hours, and (3) ensuring that children

59 wear broad-spectrum child-size sunglasses and brimmed hats and clothing that protect the skin as much as possible.

Safety If the safety of the environment or neighborhood is a concern, help parents and children find other settings for physical activity (e.g., Boys and Girls Clubs of America, recreation centers, churches and other places of worship).

Remind parents that children can do many activities indoors with soft equipment that can be used in tight spaces (e.g., modified versions of bowling, basketball, darts, or golf).

Substance Use Warn parents and children about the dangers of using alcohol, tobacco, and other drugs.

Warn parents and children about the risks of using performance-enhancing products (e.g., protein supplements, anabolic steroids). (See the the child whose BMI is between the 85th and Ergogenic Aids chapter.) 95th percentiles for age and sex and who has complications, or the child whose BMI is at or Special Issues above the 95th percentile for age and sex. (See the Obesity chapter.) Emphasize that achieving and maintaining a healthy weight is best accomplished through Encourage parents of children with special health healthy eating behaviors and regular physical care needs to allow their children to participate MIDDLE CHILDHOOD • 5–10 YEARS activity. (See the Nutrition chapter.) in physical activity for cardiovascular fitness within the limits of their medical or physical Encourage children, especially those who are conditions. Explain that adaptive physical educa- overweight, to limit sedentary behaviors (e.g., tion is often helpful and that a physical therapist watching television and videotapes, playing com- can help identify appropriate activities for chil- puter games) to 1 to 2 hours a day. dren with special health care needs. (See the Explain that weight loss should not occur during Children and Adolescents with Special Health middle childhood, with the possible exception of Care Needs chapter.)

60 Table 12. Desired Outcomes for the Child, and the Role of the Family Child Educational/Attitudinal Behavioral Health/Physical Status Enjoys physical activity Participates in daily physical Grows and develops at an activity appropriate rate Understands the importance of physical activity Participates in physical activities Maintains good health that can be sustained throughout life Uses appropriate safety equipment (e.g., helmet, wrist guards, elbow and knee pads) during physical activity

Family Educational/Attitudinal Behavioral Health/Physical Status Promotes physical activity Provides opportunities and safe Maintains good health

places for the child to partici- Understands the importance of pate in physical activity YEARS MIDDLE CHILDHOOD • 5–10 developmentally appropriate physical activities Participates in physical activity with the child Has resources that allow the child to participate in physical Provides positive role model by activity participating in physical activity Advocates for physical education in schools

61 References Branta C, Hanbenstricker J, Seefeldt V. 1984. Age changes in motor skills during childhood and adolescence. 1. Harris SS. 2000. Readiness to participate in sports. In Exercise and Sport Sciences Reviews 12:467–520. Sullivan JA, Anderson SJ, eds., Care of the Young Ath- Centers for Disease Control and Prevention. 2000. School lete (pp. 19–34). Rosemont, IL: American Academy of Health Index for Physical Activity and Healthy Eating: A Orthopedic Surgeons and American Academy of Self-Assessment and Planning Guide—Elementary School. Pediatrics. Atlanta, GA: Centers for Disease Control and 2. Willoughby C, Polatajko HJ. 1995. Motor problems in Prevention. children with developmental coordination disorder: Goldberg B, ed. 1995. Sports and Exercise for Children with Review of the literature. American Journal of Occupa- Chronic Health Conditions. Champaign, IL: Human tional Therapy 49(8):787–794. Kinetics. 3. Epstein LH. 1986. Treatment of childhood obesity. In Gould D. 1987. Understanding attrition in children’s Brownell KD, Foreyt JP, eds., Handbook of Eating Disor- sports. In Gould D, Weiss MR, eds., Advances in Pedi- ders. New York, NY: Basic Books. atric Sport Sciences—Vol. 2: Behavioral Issues (pp. 4. American Academy of Family Physicians; American 61–86). Champaign, IL: Human Kinetics. Academy of Pediatrics; American Medical Society for Green M, Palfrey JS, eds. 2000. Bright Futures: Guidelines Sports Medicine; American Orthopedic Society for for Health Supervision of Infants, Children, and Adoles- Sports Medicine; American Osteopathic Academy of cents (2nd ed.). Arlington, VA: National Center for Sports Medicine. 1997. Preparticipation Physical Evalu- Education in Maternal and Child Health. ation (2nd ed.). Minneapolis, MN: McGraw-Hill Healthcare. Hanrahan SJ, Carlson TB. 2000. Game Skills: A Fun Approach to Learning Sport Skills. Champaign, IL: 5. American Academy of Pediatrics, Committee on Sports Human Kinetics. Medicine and Fitness. 2001. Medical conditions affecting sports participation. Pediatrics 107(5):1205–1209. Harris SS. 1994. The child athlete. In Birrer RB, ed., Sports Medicine for the Primary Care Physician (2nd ed.). Boca 6. American Academy of Pediatrics, Committee on Raton, FL: CRC Press. Sports Medicine. 1990. Strength training, weight and power lifting, and body building by children and ado- Nelson MA. 1991. Developmental skills and children’s lescents. Pediatrics 86(5):801–803. sports. The Physician and Sportsmedicine 19(2):67–79. Rowland TW. 1990. Exercise and Children’s Health. Cham- Suggested Reading paign, IL: Human Kinetics. Seefeldt V, ed. 1987. Handbook for Youth Sports Coaches. Association of State and Territorial Directors of Health Reston, VA: American Alliance for Health, Physical Promotion and Public Health Education. 1997. How Education, Recreation, and Dance. to Promote Physical Activity in Your Community (2nd ed.). Washington, DC: Association of State and Terri- Seefeldt V, Haubenstricker J. 1982. Patterns, phases or MIDDLE CHILDHOOD • 5–10 YEARS torial Directors of Health Promotion and Public stages: An analytical model for the study of develop- Health Education. mental movement. In Kelso JAS, Clark JE, eds., The Development of Movement Control and Coordination (pp. Bogden JF, Vega-Matos CA. 2000. Fit, Healthy, and Ready 309–318). New York, NY: John Wiley and Sons. to Learn: A School Health Policy Guide—Part 1: Physical Activity, Healthy Eating, and Tobacco-Use Preven- Shisler J, Killingsworth R, Schmid T. 1999. Kidswalk-to- tion. Alexandria, VA: National Association of State School: A Guide for Community Action to Promote Chil- Boards of Education. dren Walking to School. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion.

62 Sullivan AJ, Grana WA, eds. 1990. The Pediatric Athlete. Parkridge, IL: American Academy of Orthopedic Surgeons. Thomas KT, Lee AM, Thomas JR. 2000. Physical Education for Children: Daily Lesson Plans for Elementary School (2nd ed.). Champaign, IL: Human Kinetics. U.S. Department of Health and Human Services; U.S. Department of Education. 2000. Promoting Better Health for Young People Through Physical Activity and Sports: A Report to the President from the Secretary of Health and Human Services and the Secretary of Education. Atlanta, GA: U.S. Department of Health and Human Services. Virgilio SJ. 1997. Fitness Education for Children: A Team Approach. Champaign, IL: Human Kinetics. Weiss MR, Petlichkoff LM. 1989. Children’s motivation for participation in and withdrawal from sports: Iden- tifying the missing links. Pediatric Exercise Science 1(3):195–211. MIDDLE CHILDHOOD • 5–10 YEARS MIDDLE CHILDHOOD • 5–10

63 I Don’t Like Sports!

Dr. Smith encourages lex, a 10-year-old boy, is encourage him when he gets frus- seeing Dr. Smith for a trated with physical activity. Alex’s parents to be A physical examination. Dr. Dr. Smith says that Alex may Smith asks Alex if he participates have a more positive experience positive role models in physical activity or sports. Alex if he tries activities with less replies, “I don’t like sports!” His emphasis on size (e.g., racquet for Alex by parents explain, “Alex would sports, martial arts, running, rather play inside with his cars and wrestling), noncompetitive activi- participating in trucks, watch TV, or play comput- ties, and activities such as walk- er games. He tried basketball last ing, hiking, biking, skating, and physical activity year but couldn’t keep up with the swimming. Dr. Smith explains other kids.” that many of these activities can themselves. Dr. Smith performs a com- be done together as a family and plete physical examination and can be sustained throughout reviews Alex’s medical history, life. growth, and development. She Dr. Smith encourages Alex’s reassures Alex’s parents that their parents to be positive role models son is healthy and has no med- for Alex by participating in physi- ical or physical conditions that cal activity themselves. She advis- would prevent him from partici- es them to limit the amount of pating in physical activity. time Alex spends watching televi- Dr. Smith also reassures sion and videotapes and playing Alex’s parents that some boys computer games to 1 to 2 hours a develop motor skills more slowly day, and to designate a specific than other boys their age. She period of time for physical activi- explains that children grow at ties that Alex enjoys. MIDDLE CHILDHOOD • 5–10 YEARS different rates and that some of Dr. Smith helps the family Alex’s 10-year-old friends may be identify physical activities that entering puberty, even though Alex likes and is willing to try, Alex hasn’t yet. Dr. Smith says and activities that Alex and his that Alex’s temporary physical parents can do together. Dr. disadvantage should not be mis- Smith indicates that she will fol- interpreted as a lack of skill or low up on these activities at ability. She emphasizes that it is Alex’s next visit. important for Alex’s parents to

64 FREQUENTLY ASKED QUESTIONS ABOUT PHYSICAL ACTIVITY IN MIDDLE CHILDHOOD

Which physical activities are best for my can do at home include stretching, calisthenics, child? aerobics, and dancing.

Your child will benefit from developmentally My child likes to watch television and appropriate physical activities he enjoys. Physical play computer games. She is not interested activities that can be sustained throughout life in sports. How can I encourage her to be are ideal (for example, walking, hiking, biking, more physically active? skating, dancing, and swimming). There are many physical activities that a child My child participates in a lot of sports. can enjoy other than sports (for example, walk- Does she need to participate in physical ing, biking, hiking, dancing, skating, and swim- education at school? ming). Limit the amount of time your child spends watching television and videotapes and Yes. Physical education will help your child learn playing computer games to 1 to 2 hours a day, about the importance of physical activity, devel- and designate a specific period of time for physi- op motor skills, introduce her to physical activi- cal activities she enjoys. Be sure to give her posi- ties that can be sustained throughout life, and tive feedback when she is physically active. keep physically fit. MIDDLE CHILDHOOD • 5–10 YEARS MIDDLE CHILDHOOD • 5–10 My neighborhood isn’t very safe. How can How can I make sure my child’s coach my child be physically active if he can’t doesn’t put too much pressure on him? play outdoors? Don't be afraid to tell the coach that you want Encourage your child’s school to provide after- your child to have fun and to develop a positive school and weekend physical activity programs. attitude toward physical activity. Explain that Also, community organizations, recreation cen- you don’t want your child to be pressured. Tell ters, and churches and other places of worship the coach that your child tends to discontinue provide opportunities for children to participate physical activity if he thinks he’s going to fail or in physical activity. Work with community lead- if there is too much emphasis on competition. ers to ensure that your child has safe places for When can my child participate in coed participating in physical activity (for example, physical activity? walking and biking paths, playgrounds, parks, and recreation centers). Also, your child can do Before puberty there are no significant differ- many activities at home with soft equipment ences between boys and girls in height, weight, that can be used in tight spaces. Examples strength, and endurance. Therefore, boys and include modified versions of bowling, basketball, girls can usually participate together in physical darts, and golf. Additional activities your child activity until puberty.

65 Resources for Families Children Aged 4 Through 11. Washington, DC: U.S. Department of Education, Office of Educational See Tool F: Physical Activity Resources for con- Research and Improvement. tact information on national organizations that can Kranowitz CS. 1995. 101 Activities for Kids in Tight Spaces. provide information on physical activity. State and New York, NY: St. Martin’s Press. local departments of public health and education, Landy J, Burridge K. 1997. 50 Simple Things You Can Do to as well as local libraries, are additional sources of Raise a Child Who Is Physically Fit. New York, NY: Macmillan. information. Micheli LJ. 1990. Sportswise: An Essential Guide for Young Cooper KH. 1999. Fit Kids! The Complete Shape-Up Program Athletes, Parents, and Coaches. Boston, MA: Houghton for Birth Through High School. Nashville, TN: Broad- Mifflin. man and Holman Publishers. Seefeldt, V, ed. 1997. Handbook for Youth Sports Coaches. Figelman AR, Young P. 1991. Keeping Young Athletes Reston, VA: American Alliance for Health, Physical Healthy: What Every Parent and Volunteer Coach Should Education, Recreation, and Dance. Know. New York, NY: Simon and Schuster. Shisler J, Killingsworth R, Schmid T. 1999. Kidswalk-to- Kalish S. 1995. Your Child’s Fitness: Practical Advice for Par- School: A Guide for Community Action to Promote Chil- ents. Champaign, IL: Human Kinetics. dren Walking to School. Atlanta, GA: Centers for Katzman CS, McCary R, Kidushim-Allen D. 1993. Helping Disease Control and Prevention, National Center for Your Child Be Healthy and Fit with Activities for Chronic Disease Prevention and Health Promotion. MIDDLE CHILDHOOD • 5–10 YEARS