Section 6: Early Childhood
6.1 Physical Development in Early Childhood
What’s physical development like in early childhood?
In early childhood, children are physically growing at a rapid pace. If you want to have fun with a child at the beginning of the period, ask them to take their left hand and use it to go over their head to touch their right ear. They cannot do it. Their body proportions are such that they are still built very much like an infant with a very large head and short appendages. By the time the child is five years old, though, their arms will have stretched, and their head will be smaller in proportion to the rest of their growing bodies. They can accomplish the task easily because of these physical changes.
- Summarize overall physical growth during early childhood
- Examine nutritional concerns during early childhood
- Describe changes in the brain during early childhood
- Give examples of gross and fine motor skill development in early childhood
- Describe sexual development in early childhood
- Differentiate between primary, secondary, and tertiary prevention
Growth in early childhood
Children between the ages of 2 and 6 years tend to grow about 3 inches in height each year and gain about 4 to 5 pounds in weight each year. The average 6-year-old weighs about 46 pounds and is about 46 inches in height. Three-year-olds are very physically similar to toddlers, with a large head, large stomach, short arms, and short legs. However, around age 3, children typically have all 20 of their primary teeth, and by around age 4, may have 20/20 vision. Many children take a daytime nap until around age 4 or 5, then sleep between 11 and 13 hours at night.
During early childhood, children start to lose some of their baby fat, making them appear less like a baby and more like a child as they progress through this stage. By the time children reach age 6, their torsos have lengthened, and body proportions have become more like those of adults. T
It should be noted that this is the growth pattern for children who receive adequate nutrition. Studies from many countries support the assertion that children tend to grow more slowly in low socioeconomic status areas and thus are smaller (Van Rossem & Pannecoucke, 2019; Neumann, September 2015; Kerr et al., 1982).
The growth rate between the ages of 2 and 6 is slower than that of infancy and is accompanied by a reduced appetite. This change can sometimes surprise parents and lead to the development of poor eating habits.
By around age 3, children will have all 20 of their primary teeth, and by around age 4, may have 20/20 vision. Many children take a daytime nap until around age 4 or 5, then sleep between 11 and 13 hours at night.
This growth rate in early childhood is not as fast as in infancy, and we see a reduced appetite between the ages of 2 and 6. This change can sometimes be surprising to parents and lead to the development of poor eating habits.
Nutritional concerns
According to the Centers for Disease Control and Prevention, 13% of children between 2 and 5 are obese, and obesity increases with age in middle childhood and adolescence (Stierman et al., 2021). The American Academy of Pediatrics (AAP) recommends a number of steps to take to help reduce the chances of obesity in young children. Removing high-calorie, low-nutrition foods from the diet, offering whole fruits and vegetables instead of just juices, and getting kids active are just some of the recommendations that they make. Muckelbauer and colleagues (2009) found that increasing water consumption in school-aged children by just 220ml (just under 8 oz) per day decreased the risk of obesity by 31%. Finally, the AAP suggests that parents can begin offering milk with a lower fat percentage (2%, 1%, or skim milk) to 2-year-olds. Switching to lower-fat milk may help avoid some of the obesity issues discussed above. Parents should avoid giving the child too much milk as calcium interferes with the absorption of iron in the diet as well.
Caregivers (whether parents or non-parents) need to keep in mind that they are setting up taste preferences at this age. Young children who grow accustomed to high-fat, very sweet, and salty flavors may have trouble eating foods that have more subtle flavors, such as fruits and vegetables. Lack of a healthy diet may lead to obesity during this and future stages. Offering a diet of diverse food options, limiting foods with high calories but low nutritional value, and limiting high-calorie drink options can all contribute greatly to a child’s health during this stage of life.
Caregivers who have established a feeding routine with their child can find the normal reduction in appetite a bit frustrating and become concerned that the child is going to starve. However, by providing adequate, sound nutrition and limiting sugary snacks and drinks, the caregiver can be assured that 1) the child will not starve and 2) the child will receive adequate nutrition. Preschoolers can experience iron deficiencies if not given well-balanced nutrition.
Tips for Establishing Healthy Eating Patterns
Consider the following advice about establishing eating patterns for years to come (Rice, 1997). Notice that keeping mealtime pleasant, providing sound nutrition, and not engaging in power struggles over food are the main goals.
1. Don’t try to force your child to eat or fight over food. Of course, it is impossible to force someone to eat. But the real advice here is to avoid turning food into some kind of ammunition during a fight. Do not teach your child to eat to or refuse to eat in order to gain favor or express anger toward someone else.
2. Recognize that appetite varies. Children may eat well at one meal and have no appetite at another. Rather than seeing this as a problem, it may help to realize that appetites vary. Continue to provide good nutrition, but do not worry excessively if the child does not eat.
3. Keep it pleasant. This tip is designed to help caregivers create a positive atmosphere during mealtime. Mealtimes should not be the time for arguments or expressing tensions. You do not want the child to have painful memories of mealtimes together or have nervous stomachs and problems eating and digesting food due to stress.
4. No short-order chefs. While it is fine to prepare foods that children enjoy, preparing a different meal for each child or family member sets up an unrealistic expectation from others. Children probably do best when they are hungry and a meal is ready. Limiting snacks rather than allowing children to “graze” continuously can help create an appetite for whatever is being served.
5. Limit choices. If you give your preschool-aged child choices, make sure that you give them one or two specific choices rather than asking “What would you like for lunch?” If given an open choice, children may change their minds or choose whatever their sibling does not choose!
6. Serve balanced meals. This tip encourages caregivers to serve balanced meals. A box of macaroni and cheese is not a balanced meal. Meals prepared at home tend to have better nutritional value than fast food or frozen dinners. Prepared foods tend to be higher in fat and sugar content as these ingredients enhance taste and profit margin because fresh food is often more costly and less profitable. However, preparing fresh food at home is not costly. It does, however, require more activity. Preparing meals and including the children in kitchen chores can provide a fun and memorable experience.
7. Don’t bribe. Bribing a child to eat vegetables by promising dessert is not a good idea. For one reason, the child will likely find a way to get the desert without eating the vegetables (by whining or fidgeting, perhaps, until the caregiver gives in), and for another reason, because it teaches the child that some foods are better than others. Children tend to naturally enjoy a variety of foods until they are taught that some are considered less desirable than others. A child, for example, may learn the broccoli they have enjoyed is seen as yucky by others unless it’s smothered in cheese sauce!
To what extent do these tips address cultural practices? How might these tips vary by culture?
Brain Maturation
By age 6, it is at 95 percent of its adult weight. The development of myelin (myelination) and the development of new synapses (through the process of synaptic pruning) continue to occur in the cortex. As it occurs, we see a corresponding change in what the child is capable of doing. Remember that myelin is the coating around the axon that facilitates neural transmission. Synaptic pruning refers to the loss of synapses that are unused. As myelination and pruning increase during this stage of development, neural processes become quicker and more complex.
Greater development in the prefrontal cortex, the area of the brain behind the forehead that helps us to think, strategize, and control emotions, makes it increasingly possible to control emotional outbursts and to understand how to play games. Consider 4- or 5-year-old children and how they might approach a game of soccer. Chances are every move would be a response to the commands of a coach standing nearby calling out, “Run this way! Now, stop. Look at the ball. Kick the ball!” And when children are not being told what to do, they will likely be looking at the clover on the ground or a dog on the other side of the fence! Understanding the game, thinking ahead, and coordinating movement improves with practice and myelination. Demonstrating resilience and recovering from a loss, hopefully, does as well.
Growth in the hemispheres and corpus callosum
Between ages 3 and 6, the left hemisphere of the brain, which tends to lag behind in terms of activity during the first 3 years of life, increases in activity, which correlates with the burst in language skills during this time period. Activity in the right hemisphere grows steadily throughout early childhood and is especially involved in tasks that require spatial skills, such as recognizing shapes and patterns. Both sides of the brain work together. There is no such thing as a person being either left-brained or right-brained. The corpus callosum, which connects the two hemispheres of the brain, undergoes a growth spurt between ages 3 and 6, resulting in improved coordination between right and left hemisphere tasks.
Visual Pathways
Have you ever examined the drawings of young children? If you look closely, you can almost see the development of visual pathways reflected in the way these images change as pathways become more mature. Early scribbles and dots illustrate the use of simple motor skills. No real connection is made between an image being visualized and what is created on paper.
At age 3, the child begins to draw wispy creatures with heads and little else. Gradually, the pictures begin to have more detail and incorporate more parts of the body. Arm buds become arms, and faces take on noses, lips, and eventually eyelashes.
Motor Skill Development
Remember that gross motor skills are voluntary movements involving the use of large muscle groups, while fine motor skills are more exact movements of the hands and fingers and include the ability to reach and grasp an object. Early childhood is a time of development of both gross and fine motor skills.
Early childhood is a time when children are especially attracted to motion and song. Days are filled with moving, jumping, running, swinging, and clapping, and every place becomes a playground. Even the booth at a restaurant affords the opportunity to slide around in the seat or disappear underneath and imagine being a sea creature in a cave! Children may frequently ask their caregivers to “look at me.” Songs are often accompanied by arm and leg movements or cues to turn around or move from left to right. Running, jumping, dancing movements, etc., help to improve children’s gross motor skills.
Fine motor skills are also being refined in activities such as pouring water into a container, drawing, coloring, and using scissors. Some children’s songs promote fine motor skills as well (“itsy, bitsy, spider” song). Mastering the fine art of cutting one’s own fingernails or tying one’s shoes will take a lot of practice and maturation. Fine motor skills continue to develop through middle childhood.
|
Age |
Gross Motor Skills |
Fine Motor Skills |
|
Age 2 |
Can kick a ball without losing balance Can pick up objects while standing, without losing balance (This often occurs by 15 months. It is a cause for concern if not seen by 2 years.) Can run with better coordination. (May still have a wide stance.) |
Able to turn a doorknob Can look through a book turning one page at a time Can build a tower of six to seven cubes Able to put on simple clothes without help (The child is often better at removing clothes than putting them on) |
|
Age 3 |
Can briefly balance and hop on one foot May walk on stairs with alternating feet (without holding onto rail) Can pedal a tricycle |
Can build a block tower of more than nine cubes Can easily place small objects in a small opening Can copy a circle Drawing a person with 3 parts Feeds self easily |
|
Age 4 |
Shows improved balance Hops on one foot without losing balance Throws a ball overhead with coordination |
Can cut out a picture using scissors Drawing a square Managing a spoon and fork neatly while eating Putting on clothes properly |
|
Age 5 |
Has better coordination (getting the arms, legs, and body to work together) Skips, jumps and hops with good balance Stays balanced while standing on one foot with eyes closed |
Shows more skills with simple tools and writing utensils Can copy a triangle Can use a knife to spread soft foods |
Sexual Health Development in Early Childhood
Historically, children have been thought of as innocent or incapable of sexual arousal (Aries, 1962). A more modern approach to sexuality suggests that the physical dimension of sexual arousal is present from birth. That said, it seems to be the case that the elements of seduction, power, love, or lust that are part of the adult meanings of sexuality are not present in sexual arousal at this stage. In contrast, sexuality begins in childhood as a response to physical states and sensations and cannot be interpreted as similar to that of adults in any way (Carroll, 2007).
Infancy
Children are capable of erections and vaginal lubrication even before birth (Martinson, 1981). Arousal can signal overall physical contentment and stimulation that accompanies feeding or warmth. Infants begin to explore their bodies and touch their genitals as soon as they have sufficient motor skills. This stimulation is for comfort or to relieve tension rather than to reach orgasm (Carroll, 2007).
Early Childhood
Self-stimulation is common in early childhood. Curiosity about the body and about others’ bodies is a natural part of early childhood as well. Consider this example. A mother is asked by her young daughter: “So it’s okay to see a boy’s privates as long as it’s the boy’s mother or a doctor?” The mother hesitates a bit and then responds, “Yes. I think that’s alright.” “Hmmm,” the girl begins, “When I grow up, I want to be a doctor!” Hopefully, this subject is approached in a way that teaches children to be safe and know what is appropriate without frightening them or causing shame.
As children grow, they are more likely to show their genitals to siblings or peers to take off their clothes and touch each other (Okami et al., 1997). Masturbation is common for both boys and girls. Boys are often shown by other boys how to masturbate, but girls tend to find out accidentally. Boys masturbate more often and touch themselves more openly than girls (Schwartz, 1999).
Hopefully, parents respond to this without undue alarm and without making the children feel guilty about their bodies. Instead, messages about what is going on and the appropriate time and place for such activities help the child learn.
Parents should take the time to speak with their children about when it is appropriate for other people to see or touch them. Many experts suggest that this should occur as early as age 3, and of course, the discussion should be appropriate for the child’s age. One way to help a young child understand inappropriate touching is to discuss “bathing suit areas.” Kids First, Inc. suggests discussing the following: “No one should touch you anywhere your bathing suit covers. No one should ask you to touch them somewhere that their bathing suit covers. No one should show you a part of their or someone else’s bodies that their bathing suit covers.” Further, instead of talking about good or bad touching, talk about safe and unsafe touching. This way, children will not feel guilty later on when that sort of touching is appropriate in a relationship.
Levels of Prevention
Between two to six years old, children are at increased risk for injuries and accidents. Unintentional injuries, like drowning, are the leading cause of death at this age (West et al., 2021). This is a fitting example of interacting domains: young kids are learning to master gross and fine motor skills, their corpus callosum is being myelinated, aiding in coordination, and their preoperational thinking drives them to actively explore their surroundings, but they don’t think logically yet, and they’re learning about the consequences of their actions by what they do and through their friends and families.
The levels of prevention are a helpful public health framework to mitigate harm (Walker & Shinn, 2002). Primary prevention is designed to prevent problems from happening to everyone at the population level. It can be thought of as the macrosystem system: laws, regulations, and national public safety announcements that increase safety for everyone. For example, poisoning used to be more common in early childhood, but primary prevention laws around child safety caps have decreased child poisoning.
Secondary prevention targets a smaller group at the highest risk of injury. For example, parental monitoring of their young children and placing medicines in a higher, locked cabinet are both secondary prevention strategies. They recognize that young kids in a family are at increased risk of poisoning and take specific actions to reduce those risks. Lastly, tertiary prevention reduces harm after the fact. For example, calling poison control after a child ingested poison to reduce any further harm is an example of tertiary prevention.
Attributions
Human Growth and Development by Ryan Newton is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License,
Individual and Family Development, Health, and Well-being by Diana Lang, Nick Cone; Laura Overstreet, Stephanie Loalada; Suzanne Valentine-French, Martha Lally; Julie Lazzara, and Jamie Skow is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License,
Human Development by Human Development Teaching & Learning Group under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License,
References
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Carroll, J. L. (2007). Sexuality now: Embracing diversity (2nd ed.). Belmont, CA: Thomson.
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Kerr, G. R., Lee, E. S., Lorimor, R. J., Mueller, W. H., & Lam, M. M. (1982). Height distributions of U.S. children: associations with race, poverty status and parental size. Growth, 46(2), 135–149.
Kids First, Inc. (2022). How to Talk to Young Children About Body Safety. https://www.kidsfirstinc.org/how-to-talk-to-young-children-about-body-safety/.
Martinson, F. M. (1981). Eroticism in infancy and childhood. In L. L. Constantine & F. M. Martinson (Eds.), Children and sex: New findings, new perspectives. (pp. 23-35). Boston: Little, Brown.
Neumann, J. (September 2015). Small height differences among kids may reflect economic disparities. Reuters, Health News. https://www.reuters.com/article/us-health-children-height-poverty/small-height-differences-among-kids-may-reflect-economic-disparities-idUSKCN0RR11720150927.
Okami, P., Olmstead, R., & Abramson, P. R. (1997). Sexual experiences in early childhood: 18-year longitudinal data from UCLA Family Lifestyles Project. Journal of Sex Research, 34(4), 339-347.
Rice, F. P. (1997). Human development: A life-span approach. Upper Saddle River, NJ: Prentice Hall.
Schwartz, I. M. (1999). Sexual activity prior to coitus initiation: A comparison between males and females. Archives of Sexual Behavior, 28(1), 63-69.
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Table adapted from NIH (2018) https://open.maricopa.edu/psy240mm/chapter/chapter-5-early-childhood/
Van Rossem, R., & Pannecoucke, I. (2019). Poverty and a child’s height development during early childhood: A double disadvantage? A study of the 2006-2009 birth cohorts in Flanders. PloS One, 14(1), e0209170. https://doi.org/10.1371/journal.pone.0209170
Walker, H. M., & Shinn, M. R. (2002). Structuring school-based interventions to achieve integrated primary, secondary, and tertiary prevention goals for safe and effective schools. In M. R. Shinn, H. M. Walker & G. Stoner (Eds.), Interventions for academic and behavior problems II: Preventive and remedial approaches (pp. 1–25). National Association of School Psychologists.
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Willoughby, M., Hudson, K., Hong, Y., & Wylie, A. (2021). Improvements in motor competence skills are associated wtih improvements in executive function and math problem-solving skills in early childhood. Developmental Psychology, 57(9), 1463–1470. https://doi.org/10.1037/dev0001223
- Table adapted from NIH (2018) https://open.maricopa.edu/psy240mm/chapter/chapter-5-early-childhood/ ↵
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