84 Grief and Loss Across the Lifespan
entry into large group situations; for others, day care or “pre-K” has socialized
them to be part of a large group of children. During early elementary school,
children begin to develop confidence in taking the initiative to move out
into the broader world, using language skills and imagination to engage
with the greater society (Erikson, 1980). Yet, some children arrive at school
angry about the attention and care they have not received from caregivers
and can be extremely disruptive because they have not learned to cooperate
with teachers and classmates. Just as the time from infancy to age 5 includes
rapid development—increased body size, mobility, and skills—so does the
period from entry into school to late elementary school age, when children
begin early adolescence. In kindergarten and first grade, children begin to
leave home for long stretches of time and must perform in different ways from
home, where they have (ideally) been nurtured and loved without many pres-
sures to achieve. For children who have not been in quality day care settings,
these new responsibilities constitute a major transition. Children may experi-
ence a loss of positive self-image as they move from the care of a loving parent
to the school environment where peers and teachers judge how well they fit.
Elementary school children thrive on structure and stability, particularly
in their younger years. Neuropsychiatrist (with pediatric training) Dan Siegel
describes this as a time children learn to navigate between chaos and rigidity,
between a lack of control and impulsivity and inflexible adherence to rules
(Siegel & Bryson, 2011). Children this age need help processing their emotions;
they must learn to adapt to circumstances, build empathy, and increase their
ability to attend to their own well-being (Siegel & Bryson, 2011). Kelsey felt her
stability threatened and responded with inflexibility; luckily, her mother knew
to help Kelsey feel safe and to create more opportunities for Kelsey to verbal-
ize her concerns about adapting to the new circumstances.
For children who have not received love and unconditional acceptance
in their home environment, school may provide a haven where achievements
lead to praise and an increased sense of self-efficacy. As children move into
the higher elementary school grades, they industriously learn and produce
projects and papers and engage in creative, athletic, and other endeavors. The
ability to produce in this way promotes a sense of mastery; but the child who
is unable to meet this level of industry often experiences a sense of inade-
quacy and inferiority (Erikson, 1980). Ultimately, if the children can meet the
social and academic expectations of the school environment, they will likely
thrive in the social world that will now occupy the vast majority of their
waking hours.Biological Development
Children nearly double their weight and height between the ages of 5 and 11.
Fiftieth percentile 5-year-olds weigh 42 pounds and are about 43 inches tall. By
age 11, a child in the fiftieth percentile weighs 82 pounds and is 57 inches, or
nearly 5 feet tall. At the same time, the brain becomes more complex. Children’s
brains show growth in the prefrontal cortex as well as the temporal and occipi-
tal cortices (Sowell et al., 2004). Sowell et al. also found changes in the rela-
tionship between gray matter and white matter in the brains of children as