At age 6 years (finishing kindergarten or starting first grade), a child has
mastered the simple skills needed for an academic base. Children at this age
demonstrate a transition from "preoperational" thinking to
"operational" thinking, as described by Piaget.
Preoperational thinking is
characterized by magical and egocentric thinking.
The child who has preoperational skills is very centered in his or her
perspective and finds it difficult to understand that other people can look at
things differently. In contrast, concrete
operational thought is
characterized by the ability to consider multiple variables, understand serial
relationships (alphabet, word formation) and
classification systems (handedness), and perform
mental operations relating to objects (counting).
Accordingly, the child described in the vignette most likely knows her right
hand from her left.
Most 6-year-olds do not yet have the visuomotor coordination to hit a baseball,
although they may be able to play t- all. These
children may be able to obtain a drink or open a packaged
meal, but they cannot yet organize and cook a meal.
Letter formation is still awkward at this age, with large letters.
Reading is primarily by word recognition, although
6-year-old children may be starting to use phonetics.
Developmental evaluation should be included in health supervision visits at this
time to assess a child's school readiness and probability of academic success.
Verbal skills and general knowledge
can be appraised through general questions such as "Where
do you go to school?" and "What is your telephone number?". Asking the
child to copy a cross (4- ear-old), square (5-year-old),
triangle (6-year-old), or diamond (7-year-old) can evaluate handedness,
graphomotor skills, and visual-perceptual skills. Asking the child, "What makes
the sun come up in the morning?" and "What really happens to the people on
television who fly or get hurt?" can assess his or her beliefs regarding
causality and capacity to distinguish between reality (concrete operational
thinking) and fantasy (preoperational thinking).
References:
Dixon SD, Stein MT. Encounters With Children: Pediatric Behavior and
Development. 3rd ed. St Louis, Mo: Mosby, Inc; 2000
Piaget J. The Origins of Intelligence in Children. New York, NY:
International Universities Press; 1952
Smith PK, Cowie H. Understanding Children's Development. 2nd ed.
Cambridge, Mass: Blackwell Publishers; 1991