According to psychoanalytic theory, sexual development is biphasic, with a “latent” period during the school-age years. Freud believed that latency was a distinguishing feature of humans over animals, and hoped to discover anatomical evidence of this through then-promising studies of changes in the interstitial portions of the “sex glands” (9). However, contemporary studies of sex hormones do not support the biphasic theory. Infants have relatively high but varying proportions of sex hormones in cord blood. The levels of sex hormones fall after birth and begin to rise, due to endogenous production, during the school-age period (ages 7–8 in girls, and about 2 years later in boys). Sex hormones begin a gradual upsurge around age 8, continuing through the pubertal peak. Children engage in some sexual play with self and others. Retrospective interviews with homosexual adults generally pinpoint middle childhood as the time when sexual preference was established. Some have postulated that school-age children’s greater sexual awareness may be reflected in their expressed feelings of disgust and shame and the strong sense of modesty that develops during the school years. Others have reported that sex play among school children is a natural extension of that of preschoolers (10). Infants and toddlers masturbate; preschoolers also engage in mutual exploration. Psychoanalytic theory posits that sexual strivings in the Oedipal child are overcome with the development of defense mechanisms. Children often enter middle childhood with a few good friends of the opposite sex. Around, age 8, however, the same-sex groupings become polarized, with the opposite gender having developing “cooties” and being generally avoided or teased. Moving toward preadolescence, however, the “yuckiness” of the opposite sex gradually gives way to admiring certain individuals from a distance. Older school-age girls’ budding attraction to movie stars and rock

idols serves a group interactional function, as well as helping to define identity. As with preschoolers, if school-age children are preoccupied with sexual themes, it is wise to look for the possibility of sexually stimulating experiences, such as sexual abuse or witnessing of sex acts.

There is a wide range of both timing and tempo of pubertal onset, and it begins for many girls near the end of what is traditionally termed middle childhood. The onset of puberty at age 9–11, as measured through breast growth, correlates with a positive body image, positive peer relationships, and superior adjustment in girls (11). Conversely, a slower maturational pace may wreak havoc on social relationships, as peers realign themselves with children who are perceived to possess more attractive or desirable traits.

It is well established that children adopt a firm gender identity by age 3. This expression of their maleness or femaleness is manifested early by choices of role models and friends. With gender differences, as with so many of the other issues discussed in this chapter, the question of what is innate and what is the outcome of socialization remains intriguing.

John Money’s (12,13) studies of infants with ambiguous genitalia established that gender identity was primarily determined through socialization. But explorations of differences in sexual preference and transsexual behaviors have raised questions about the roles of sex hormones in determining gendered behaviors. Carol Jacklin (14) reviewed a number of purported relationships of hormones to behavior. There were no consistent findings and many weaknesses with the studies. Jacklin proposed that the internal representation of one’s gender, which she refers to as schemata (changing and evolving networks of associations to filter and organize information about oneself, one’s gender, and its meaning) evolve out of diverse information, including modes of behavior, properties of objects, attitudes, and feeling states. Information is both presented and processed differently for boys and girls. For example, Jacklin notes how rare it is to see someone compliment a girl on how strong she is getting, or a boy on how nurturing he is. Although observational research documents little difference in parental treatment of boys versus girls (15), children’s sex-stereotyped views of parental roles in society nevertheless become ingrained and persist through the school years into adolescence (16).

A number of characteristics are associated with being male or female in the school-age period. Carol Gilligan (17) cites Janet Lever’s studies of 181 fifth-grade children at play. She observed that boys play outdoors in large and heterogeneous groups, and they play competitive games that last longer than those of girls. The games played by boys are full of disputes that seem to add interest to the interaction and do not derail the game. Similar observations of children playing led Jean Piaget to conclude that boys were more advanced in moral development because of their fascination with legal procedures and experience at generating fair arbitration of disputes. Many others concluded similarly that in the area of moral development and the development of the capacity to exert effective leadership in complex groups, boys preceded girls; few girls ever caught up.

In proposing that women listen to the demands of socialization and morality “in a different voice,” Gilligan added new value to this “instrumental versus expressive” gender dichotomy. Gilligan’s descriptions of different lines of moral development for boys and girls will be discussed later in the review of moral development during school age.

Recognizing that boys generally develop instrumental functions and girls expressive ones has provided explanations for other observed differences between boys and girls. In academic achievement, for example, girls traditionally have tended to do better in verbal areas, while boys have done better in math and science. Even as the causes of these differences are being explored, they are also being denied and recharacterized. Feminism apparently has had its effects on gender identity and gender role behaviors in both girls and their mothers. For example, the widely held view that boys are more mathematically capable than girls has been demonstrated to be more an effect of socialization than innate capability. Math anxiety was related to gender-stereotyped beliefs of parents, the mothers being most influential (18). Furthermore, gender differences in academic skills that had been previously noted are now not found on many tests of academic competence (14). It is likely that other so-called innate gender differences will be similarly reevaluated in the future. Still, Gilligan et al. (19), in a Harvard research study, describe “hitting the cultural wall”; when preadolescent girls realize that society values appearance more than accomplishment, they become more self-critical and worry about their weight. A negative body image was found to be associated with high IQ. In the American Association of University Women’s Shortchanging Girls, Shortchanging America, a study of 3,000 girls and boys in fourth through tenth grade concluded that girls lose their positive self-esteem and switch to appearance as the primary way to measure themselves (20). Other studies (21,22) support that preadolescent girls are more likely to get depressed, have their IQ scores drop, and decline in math and science.

The standard by which school-age children’s cognitive competence has been evaluated is the achievement of what Jean Piaget termed “concrete operations.” The preschooler’s preoperational thought is a creative effort to grasp causality and make meaning of experience using idiosyncratic and egocentric logic. In contrast, school-age children master important operations that increase their objectivity and their ability to be conventional.

Classification and conservation are the two crucial achievements of concrete operational thinking. Classification is the ability to group objects or concepts; conservation is the ability to recognize constant qualities/quantities of material even when the material undergoes changes in morphology. The concrete logical operations enable the child to deal systematically with hierarchies and categories, series and sequences, alternative and equivalent ways of getting to the same place, and reciprocal relationships. They include:

Logical operations are crucial to mastering basic reading and mathematics skills, and they are also necessary for conducting social interaction, with its increasing complexity of groups, games, and rules. Acquisition of the ability to do conventional and objective mental operations is associated with an interest in the scientific workings of the birth process, and a grasp of the finality, universality, and inevitability of death.

Successful school-age children have not just the ability to perform the specific concrete operations themselves but also
the ability to communicate about them in conventional ways. They understand that there are conventions of conversation, response to questions on tests, and social comportment. With cognition, as with almost every other aspect of the school-age youngster’s development, joining society and sharing conventions is the key to success. This interest in conventions and rules is frequently accompanied by a fascination with ordering and ritual. For example, school-age children often develop favorite numbers, magical rituals (“Step on a crack, break your grandmother’s back”), or the need to do things in even pairs. They may also become collectors of coins, stamps, insects, baseball cards, comic books, and such and may spend a great deal of time reviewing and ordering their collections.

During middle childhood, attention becomes increasingly selective. The ability to plan before taking action also develops (24). The school-age child’s theory of mind (metacognition) is increasingly sophisticated, viewing the mind as an active and reflective information processor (25). Children become aware of their own mental processes, private speech, and choice of memory strategies. However, school-age children are just beginning to develop cognitive self-regulation. One predictor of academic success is the ability to effectively self-regulate (26).

Along with the development of concrete operations, a child’s sense of morality, that is, the appreciation of consequences and justice, evolves from an egocentric, idiosyncratic, and often harsh system of evaluations of behavior by punishment, to adopting internalized rules for evaluating behavior.

Piaget (27) posited that school-age children’s morality is in the “interpretation of rules” stage. This accomplishment permits the child to understand the spirit of a rule and to make subjective moral judgments.

Kohlberg (28) described the moral development that most school-age children reach as the level of “conventional morality.” Conventional morality contains two stages: “interpersonal concordance” and “orientation toward authority.” In the stage of “interpersonal concordance” a child measures behavior and judges it on the basis of whether it pleases those he looks up to. These mutual interpersonal expectations are those of a “good girl” or “good boy,” who wants to please her or his parents and teachers, and obeys the Golden Rule (“Do unto others as you would have them do unto you”). The next stage in conventional morality, “orientation toward authority,” reflects the societal values of duty, respect, and law and order. This differs from the stage of interpersonal concordance in that the child’s moral compass is now set by the social system instead of the immediate social context of family, school, or neighborhood. The child supports the rules of society, believes that it is essential not to break these rules in order for society to function, and makes moral judgments based on how well an individual situation conforms to the rules of the social system.

Gilligan’s (14) studies of girls’ and women’s moral development led her to emphasize the importance of relationships. In contrast to the traditionally masculine, seemingly quasimathematical system for evaluating moral choices, Gilligan finds that girls use a form of narrative that evolves solutions within conversations and interpersonal action. Thus, Gilligan interprets the fifth-grade girls’ play observed by Lever (described earlier) not as poorly developed or socially immature but as valuing different aspects of the social experience. Gilligan describes the different response of an 11-year-old boy and girl, both of whom were at the top of their sixth grade class in a private elementary school in an academic community. The moral test question was that of the man whose wife is gravely ill and whose survival depends on receiving a specific medicine. The medicine is too expensive and the pharmacist will not reduce the price. The man breaks into the pharmacy and steals the medicine for his wife. In responding to the question of what should happen to the man, the boy thoughtfully weighed the problem of laws against stealing and a higher law valuing life. The girl, on the other hand, felt that the various parties needed talk to each other, and could not render an opinion about what should happen to him. She was aware of the rules, but felt that the conflict was such that mediation was needed to reach a resolution.

There has been significant critical reanalysis of Gilligan’s data and conceptualization of the gender differences in moral reasoning. For both girls and boys, the development of morality reflects conventional thinking and measuring their evaluations with the rules of their society, as they understand them. Although moral reasoning continues to evolve through and beyond adolescence, many of the standards that are developed for our own behavior during middle childhood are likely to remain internalized and used as self-evaluation measures into adulthood.

Stilwell, et al., in a study of 132 students aged 5–17 years, describes moral development as a natural outgrowth of attachment, evolving through five stages (29). First, the child’s sense of security and experience of empathic responsiveness become paired with a sense of moral obligation. Next, the caretaker’s rules are incorporated. Then, an understanding develops of how empathy can modify strict rule following. Next, ideals and role models are selected that reflect earlier learning in attachment relationships. Finally, the self is visualized as a keeper of moral standards. These stages roughly correlate with Kohlberg’s stages of morality, but emphasize the grounding of morality and conscience in the early and fundamental experience of attachment and secure base, out of which empathy develops.