Reflection on Child Observation in The Middle Childhood Stage

People in society spend a lot of time observing, whether we are intentionally or unintentionally aware of it. People observe through their environment and day-to-day activities that transpire. Observations can be done through engaging in different actions and environmental settings such as public transportation, restaurants, hospitals, work and shopping amongst others. As a social worker in training, it is important for me to observe competently to be able to effectively assess the safety and environment of clients, which will strengthen my skills and help me in determining what treatment options, may be best for children and families.

The life stage used for this focal observation was the middle childhood stage. Children in this stage (4) ages ranges from age five or six and ends at ages ten to twelve. I choose this life stage because I believed I could gather more data through observance. The middle childhood phase is typically when children began to expand their roles and began to develop their identities in society. Many changes began to take place for them socially, cognitively, and ecologically. Hutchinson (2015) states” During middle childhood, the child’s social world begins to expand dramatically.”

The observation took place on April 16th, 2019, approximately 8:05pm in the Bronx, NY at Lincoln hospital, in the ICU surgery unit, waiting area on the 9th floor. The observation occurred for almost twenty minutes. A hospital is an institution that provides medical care and treatment to individuals who are sick and injured and which many children dread going to. Children often associate the hospital with undesirable feelings based on their childhood experiences; such as receiving required vaccinations during the infancy and toddlerhood stage.

Inside the hospital, I remember the walk from the elevator to the waiting room being really long. The walls in the ICU unit were taupe and the lights were dim, which represented a dull and lifeless feeling. In the waiting area, there was one tv mounted on the wall, a patient bills of rights chart hanging up by the door and two vending machines opposite from the 8 chairs. One filled with unhealthy snacks and the other filled with sugary drinks such as Pepsi, Sunkist, and fruit punch. The smell in the hospital was reminiscent of a chemical smell that most hospitals have. There was medical equipment present in the halls such as EKG machine and blood pressure monitor. Medical professionals were moving around and working. The atmosphere in the hospital was very low; sadness was conveyed via facial expressions and body language.

Before starting this observation, I remember feeling emotional. I was in the hospital visiting a love one that fell really ill and was in surgery. I didn’t plan on actually conducting my observation there. I planned on conducting it in a different setting such as a supermarket or movie theater. However, when I arrived and got settled, I noticed that there was a child in the waiting room, the only kid I actually came across over the last two weeks in the ICU unit during my visits to the hospital. I began to think how difficult it must be for him. What emotions were going through his head? Was he nervous or scared? Did he want to even be here? For me, as an adult I was going through many feelings and dealing with my own anxieties. It’s hard going to the hospital to see a love one who’s sick and need extra care, knowing that we can’t physically make them feel better. For a child that experience can be traumatizing furthering impacting their cognitive skills and functioning.

The middle childhood stage falls under Erikson category 4 which is industry vs. inferiority. This is the stage when children typically began to do things on their own and gain a sense of independency. Although they brain grows to ninety percent of its adults’ size in the early childhood stage. During the middle childhood they began to build their self-image, being able to make decisions and assert themselves. Most children began their school journey during this stage (preoperational thought). Increasing their cognitive development, self- confidence, social skills, and gaining more independence as they come into contact with larger society. Such as teachers, churches, fellow classmates, librarians, bus drivers, sporting activities, etc.

During my observation I noticed the child more than likely went straight to the hospital from school, because he still had his book bag with him. The boy who appeared to be around eleven, had on jeans, a long sleeve top, old sneakers and look like he can use a haircut. In addition, I observed he was overweight for his age. This was an indicator that he may not be physically active, or his family may be experiencing financial issues. According to Hutchinson (2015) “the nature and pace of physical growth during this period are shaped by both genetic and environmental influences.”

I observed the child playing on an iPhone for about 5-8 minutes, until mom asked for it. The child also was very inquisitive asking a lot of questions about different topics ranging from school to his grandma who was sick in the hospital. He spoke articulately, displaying his language development. According to Cohen (2016) “Language continues to develop and by the end of this stage children have an average vocabulary of 40,000 words.” However, the most apparent developmental skill displayed during the observation, was emotional intelligence. The child was able to tune into his mom feelings and sympathize with her, by rubbing her hand and displaying affection and compassion. Presenting advance coping skill during this difficult time. According to Davidson, Tish, Am and Michael Mazzei (2016) “Children ages 7 to 11 display a wider variety of self-regulation skills. Sophistication in understanding and enacting cultural display rules has increased dramatically by this stage.”

Cognitively, he was able to display formal operations; showing the ability to understand people and circumstances that takes place within his proximal environment. Family and peer groups are important influential systems for children in the middle childhood stage; they typically are seeking a desire to feel accepted as they constantly compare themselves to others in society. Positive peer and family relationships has a significant impact on their development. Tomonari, Dana, and Rachelle Feiler (2003) “Middle childhood is also a time when children develop competence in interpersonal and social relationships. Children have a growing peer orientation, yet they are strongly influenced by their family.”

The subject of the observation was Hispanic. Based on my assessment, the child appeared to be from a low socio-economic background. The possibility of walking home was mentioned, this was an indicator that they must live within close range to the hospital. The south Bronx is the poorest county in New York City. A large amount of families in the Bronx are living below the poverty line. Hutchinson (2015) states “Limited income constrains a family’s ability to obtain or invest in resources that promote positive development.”

Studies shows many families who live in the Bronx are amongst the oppressed group, often faced with social inequalities in society such as unstable housing, lack of adequate support system, poor education systems, poor health care and unequal access to gainful employment. In addition, studies show the Bronx has higher asthma rates. All which can have a profound impact on children. Hutchinson (2015) states” Economic poverty often includes emotional, spiritual, and support system improvements.” This often manifest into many families not having access to resources, guidance, and support needed to thrive in society. Such as financially being unable to afford healthier food options due to the cost, leaving many families stuck buying fast food and unhealthier options from the supermarket because it’s significantly cheaper; posing a threat to children’s physical wellbeing.

Hutchinson (2015) states” Poverty is the most significant human rights challenge facing the world community. Foremost among threats to children’s healthy development is poverty, which potentially threatens positive development in all domains”. Poverty can have a significant impact on the upbringing of children. Ultimately, impacting them as they become adults. Risk factors includes community violence, low self-esteem, ineffective discipline, divorce, failing schools, and poor nutrition which negatively impact their health, eating habits, school success, and relationships with family and friends.

Based on the environment and setting of the observation, I honestly think my presence had no effect on the child I observed. Due to the circumstances the child was focused on providing support for his mom and loved one whom was in the hospital. For me, I was in awe that a child was able to put his feelings to the side to step up and be there for his mom. Exhibiting masculine identification as he showed strength and leadership. Which seem to come naturally for him.

Based on my observation, the case falls under the system perspective. The system perspective views human behavior as the outcome of interaction within and among systems of interrelated parts. For children in the middle school stage, both internal and external systems play a major role in their development. Systems such as family, schools, friends, health care, and other environmental factors are all significant for children development during that stage. I agree with Hutchinson, as I think back to my middle childhood experiences, I remember how the support of my family, teachers and friends gave me the self-confidence I needed to believe I can do anything I put my mind to. However, when children don’t come from supportive homes or have supportive systems in place the outcome can be very different. According to Hutchinson (2015) “Family, peer and community support may enhance the child’s growing sense of competence; lack of such support undermines this sense.”

The child was able to show self-awareness; being able to be mindful and understand what was happening and display sustainment for his mother. He was also very attentive; displaying his emotional attachment to his mother. It’s during the infant-child development that children cognitive and emotional development begins, setting the foundation for the rest of the stages of development such as cognitive development, physical development, and emotional development. In addition, love and nurturing is crucial which plays a vital role for children in the early stages of development. Allhussen illustrates “their development is more like walking up a grand staircase with multiple plateaus. Within a level they are always making advances, and those advances taken together help prepare them for the next level.”