Wellbeing, participation and connection in the middle years of childhood

IF 6.7 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Medical Journal of Australia Pub Date : 2024-11-17 DOI:10.5694/mja2.52495
Sharon Bessell, Tim Moore, Gerry Redmond
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The purpose of this article is to highlight the relationship between participation, health and wellbeing, for children aged in the middle years.</p><p>Middle childhood, defined here as between six and 12 years of age, corresponds with primary school. But children's lives are characterised by more than school. During middle childhood, children begin to gain independence while remaining strongly connected to their families, yet children's place is often understood to be either the family or school. Limiting children's domains to family and school has resulted in the privatisation of childhood and in their exclusion from public spaces, with deleterious impacts on social relationships.<span><sup>1</sup></span> Loneliness among children in middle childhood may result from a lack of social connection and has serious implications for health and wellbeing.<span><sup>2</sup></span> These concerns are exacerbated in a context of polycrisis encompassing challenges to children's wellbeing and mental health, from climate change to conflict, failing systems across welfare, education and health care and declining standards of living.<span><sup>3</sup></span> Given the significance of middle childhood and complexity within which children live, there has been insufficient policy consideration of children's lives beyond school and family. Yet engagement with community, beyond school and family, is essential for children's sense of belonging, and their overall health and wellbeing.<span><sup>4</sup></span> Without policy support, children's engagement with community is especially challenging for those whose families are under stress or experiencing financial hardship.</p><p>Our argument here is twofold. First there is a need for policies and services to be more responsive to middle childhood. In Australia, there is a strong and justifiable focus on the early years. Yet, as we create the conditions in which children and their families can thrive during the early years of life, we need to take care not to create a policy and service cliff as children move into middle childhood. Our second argument is that efforts to foster children's health and wellbeing must consider how to build child-inclusive communities that are welcoming to children and in which children can actively participate in ways that are meaningful to them. The Future Healthy Countdown 2030<span><sup>5</sup></span> presents an opportunity to advocate for children in middle childhood and foster child-inclusive communities that create pathways for children's social and civic participation.</p><p>Policy focus on the early years, in Australia and globally, is justified by a vast body of evidence.<span><sup>6, 7</sup></span> Although Australia has long invested in young children, in the past, this has been primarily through cash transfers.<span><sup>8</sup></span> Over the past decade, the policy focus has expanded to education, health and wellbeing. This is exemplified by the National Early Years Strategy, launched in May 2024, which promotes the vision that “All children in Australia thrive in their early years. Children have the opportunity to reach their full potential when nurtured by empowered and connected families who are supported by strong communities”.<span><sup>9</sup></span> The Australian Early Development Census provides powerful data across key dimensions of children's development (https://www.aedc.gov.au); the national Measuring What Matters Framework (https://treasury.gov.au/policy-topics/measuring-what-matters) includes a number of indicators for early childhood, and the establishment of a Minister for Early Childhood Education all point to a strong and growing commitment to ensuring children are well supported during the first five years. Yet the role of middle childhood in providing a critical bridge from the early years to youth is neglected in policy in Australia and globally.<span><sup>10</sup></span></p><p>There is also a strong focus on youth. The National Office for Youth (https://www.youth.gov.au/) aims to connect young people and government, creating opportunities for genuine engagement and partnership in the development of policies and programs. The national youth strategy Engage! (https://www.youth.gov.au/engage) defines young people as aged 12–24 years. The Office for Youth steering committee comprises young people aged 13–24 years, and youth advisory groups consist of young people aged 16–25 years providing advice on a range of policy issues.<span><sup>11</sup></span> Although these developments are welcome, they also highlight a significant policy gap for young Australians aged between six years and early adolescence. There is a missing middle.</p><p>The invisibility of middle childhood undermines children's wellbeing and acts as a barrier to their social and civic participation. When children are isolated from their communities and have few intergenerational relationships or “adult champions” outside of school and family, they are more vulnerable to abuse and feel less safe.<span><sup>12</sup></span></p><p>In most wealthy countries, children's lives tend to be bounded and shaped by two institutions: home and school.<span><sup>13</sup></span> Public spaces are generally considered to be the domain of adults, where children are only welcome when accompanied by adults and/or engaging in ways that are acceptable to the adults, who are considered to legitimately occupy the space.<span><sup>14</sup></span> The exclusion of children in middle childhood from public spaces, in Australia and elsewhere, is often justified on the grounds of protecting them from the dangers posed by strangers and traffic.<span><sup>15</sup></span> The result is the privatisation of childhood,<span><sup>1</sup></span> raising crucial questions around children's wellbeing, sense of belonging, safety and relational health. When childhoods are confined to private spaces, the potential for social isolation and exclusion becomes real.</p><p>In policy terms, middle childhood is dominated by education. Children's wellbeing is enhanced when they are able to actively participate in school activities and decision making. Yet policies to promote active student participation are often inadequate and inconsistent.<span><sup>16</sup></span> Schools are responsible for an ever-growing range of issues, from providing meals to ensuring children's wellbeing and mental health to addressing child protection concerns, in addition to delivering the nationally agreed curriculum. In the wake of restrictions due to the coronavirus disease 2019 (COVID-19) pandemic, there have been calls for schools to be further expanded and reimagined as multi-opportunity communities.<span><sup>17</sup></span> Yet children's lives also exist beyond the school gates. The institutionalised nature of childhood means that there are few pathways for children to actively take part in social and civic activities outside of school. When children do participate in social and civic activities, adults (usually parents or families with the necessary resources, and sometimes teachers) are needed to act as conduits. Making schools the primary, or only, focus of policy and programs for children in middle childhood is problematic, and restricts children's lives to a single institution outside of their family in ways that marginalise them from their broader communities. Moreover, the reliance on schools and education policy in delivering children's wellbeing ignores the range of influences beyond schools that shape children's lives.<span><sup>18</sup></span></p><p>Community inclusion and participation has the potential to deliver positive outcomes for children's health and wellbeing and reduce the reliance on schools as the dominant or sole institution responsible for supporting children or providing intergenerational relationships.<span><sup>19</sup></span> Each of the authors of this article has undertaken research with children that has consistently highlighted the extent to which children value social and intergenerational relationships.<span><sup>20</sup></span> Children in the middle years have told us that their sense of wellbeing is strengthened when they feel respected and valued and when they believe that they have adult allies who work with them in solidarity.<span><sup>21</sup></span> However, children also tell us that they are taught to be scared of adults, that adults downplay their concerns and worries, and, increasingly, that adults outside of their families and schools can be reluctant to build relationships with them.</p><p>The Australian Child Wellbeing Project found that family and friends consistently ranked as priorities for children in year 4, year 6 and year 8.<span><sup>22</sup></span> School also ranked as important, but children were often somewhat ambivalent about it. Interestingly, almost one quarter of children in year 4 identified neighbourhood and community as important, but, by year 8, under 8% of children prioritised neighbourhood and community.<span><sup>22</sup></span> In the Children and Communities in Australia project, children in middle childhood spoke of wanting to be part of and contribute to their communities, but often felt that there was no place for them.<span><sup>19</sup></span> The exclusion of children in middle childhood from their communities might explain the decline in the importance children place on community or neighbourhood as they become older. Children who participated in the Children and Communities project also described feeling safer in their communities when they knew and trusted adults beyond their families.</p><p>Feeling respected and listened to is crucial to children's own sense of wellbeing, but, too often, children describe feeling ignored and marginalised. Social relationships are essential to children's sense of wellbeing. Strong and supportive relationships help children to develop a sense of competence and agency.<span><sup>23</sup></span> Positive and trustworthy relationships are especially important for children who have experienced abuse or neglect and have complex needs.<span><sup>24</sup></span></p><p>Ensuring the wellbeing of children in middle childhood requires us to consider their place and participation not only within the institution of school but beyond. It is also essential to recognise that children's opportunity to actively participate in their communities is shaped by their family's resources, socio-economic status, knowledge of what is on offer, and connections. The opportunity to participate in social and civic activities is not only narrow for children in middle childhood, it is also unequal.<span><sup>25</sup></span> Children who live in disadvantaged communities have described feeling unwelcome in affluent communities and worry that they will be blamed if something goes wrong.<span><sup>26</sup></span> Children from families under stress and who are fearful about judgment can be particularly isolated and describe feeling invisible.<span><sup>11</sup></span></p><p>Ensuring the health and wellbeing of all children requires an understanding of the intersecting issues that shape and constrain their civic and social participation, from involvement in sport and recreational activities through to participation in community leadership roles. It requires active efforts to genuinely include and support children and families who are on the margins.</p><p>In developing policies to promote children's health and wellbeing, it is essential that middle childhood is made visible, and children in this age cohort are listened to. The current gap between ages six and 12 years is a significant shortcoming in the Australian policy landscape, but one that can be addressed by actively creating pathways for children in this age cohort to participate in and be part of their communities. In doing so, it is important to be focused on the contribution that safe and trustworthy social relationships make to children's sense of wellbeing. It is also essential that children are actively involved in determining the types of activities and connections needed to create child-inclusive societies that genuinely support children in middle childhood. As we reimagine children's place within our communities, and our policies, the role of school must remain crucial, but not to the exclusion of all else. Children in middle childhood should be visible, valued and included across community life; their health and wellbeing now and into the future depends on it.</p><p>No relevant disclosures.</p><p>Not commissioned; externally peer reviewed.</p>","PeriodicalId":18214,"journal":{"name":"Medical Journal of Australia","volume":"221 S10","pages":"S23-S25"},"PeriodicalIF":6.7000,"publicationDate":"2024-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.5694/mja2.52495","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical Journal of Australia","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.5694/mja2.52495","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Ensuring the health and wellbeing of children is a fundamental societal goal, which is best achieved when children are connected to their communities, have opportunities for meaningful participation, and enjoy strong and supportive relationships across generations, within and beyond their families. This means investing in individual children and families and in their communities. It also means creating communities that are inclusive of children and actively providing pathways for children to participate in a range of social and civic activities. The purpose of this article is to highlight the relationship between participation, health and wellbeing, for children aged in the middle years.

Middle childhood, defined here as between six and 12 years of age, corresponds with primary school. But children's lives are characterised by more than school. During middle childhood, children begin to gain independence while remaining strongly connected to their families, yet children's place is often understood to be either the family or school. Limiting children's domains to family and school has resulted in the privatisation of childhood and in their exclusion from public spaces, with deleterious impacts on social relationships.1 Loneliness among children in middle childhood may result from a lack of social connection and has serious implications for health and wellbeing.2 These concerns are exacerbated in a context of polycrisis encompassing challenges to children's wellbeing and mental health, from climate change to conflict, failing systems across welfare, education and health care and declining standards of living.3 Given the significance of middle childhood and complexity within which children live, there has been insufficient policy consideration of children's lives beyond school and family. Yet engagement with community, beyond school and family, is essential for children's sense of belonging, and their overall health and wellbeing.4 Without policy support, children's engagement with community is especially challenging for those whose families are under stress or experiencing financial hardship.

Our argument here is twofold. First there is a need for policies and services to be more responsive to middle childhood. In Australia, there is a strong and justifiable focus on the early years. Yet, as we create the conditions in which children and their families can thrive during the early years of life, we need to take care not to create a policy and service cliff as children move into middle childhood. Our second argument is that efforts to foster children's health and wellbeing must consider how to build child-inclusive communities that are welcoming to children and in which children can actively participate in ways that are meaningful to them. The Future Healthy Countdown 20305 presents an opportunity to advocate for children in middle childhood and foster child-inclusive communities that create pathways for children's social and civic participation.

Policy focus on the early years, in Australia and globally, is justified by a vast body of evidence.6, 7 Although Australia has long invested in young children, in the past, this has been primarily through cash transfers.8 Over the past decade, the policy focus has expanded to education, health and wellbeing. This is exemplified by the National Early Years Strategy, launched in May 2024, which promotes the vision that “All children in Australia thrive in their early years. Children have the opportunity to reach their full potential when nurtured by empowered and connected families who are supported by strong communities”.9 The Australian Early Development Census provides powerful data across key dimensions of children's development (https://www.aedc.gov.au); the national Measuring What Matters Framework (https://treasury.gov.au/policy-topics/measuring-what-matters) includes a number of indicators for early childhood, and the establishment of a Minister for Early Childhood Education all point to a strong and growing commitment to ensuring children are well supported during the first five years. Yet the role of middle childhood in providing a critical bridge from the early years to youth is neglected in policy in Australia and globally.10

There is also a strong focus on youth. The National Office for Youth (https://www.youth.gov.au/) aims to connect young people and government, creating opportunities for genuine engagement and partnership in the development of policies and programs. The national youth strategy Engage! (https://www.youth.gov.au/engage) defines young people as aged 12–24 years. The Office for Youth steering committee comprises young people aged 13–24 years, and youth advisory groups consist of young people aged 16–25 years providing advice on a range of policy issues.11 Although these developments are welcome, they also highlight a significant policy gap for young Australians aged between six years and early adolescence. There is a missing middle.

The invisibility of middle childhood undermines children's wellbeing and acts as a barrier to their social and civic participation. When children are isolated from their communities and have few intergenerational relationships or “adult champions” outside of school and family, they are more vulnerable to abuse and feel less safe.12

In most wealthy countries, children's lives tend to be bounded and shaped by two institutions: home and school.13 Public spaces are generally considered to be the domain of adults, where children are only welcome when accompanied by adults and/or engaging in ways that are acceptable to the adults, who are considered to legitimately occupy the space.14 The exclusion of children in middle childhood from public spaces, in Australia and elsewhere, is often justified on the grounds of protecting them from the dangers posed by strangers and traffic.15 The result is the privatisation of childhood,1 raising crucial questions around children's wellbeing, sense of belonging, safety and relational health. When childhoods are confined to private spaces, the potential for social isolation and exclusion becomes real.

In policy terms, middle childhood is dominated by education. Children's wellbeing is enhanced when they are able to actively participate in school activities and decision making. Yet policies to promote active student participation are often inadequate and inconsistent.16 Schools are responsible for an ever-growing range of issues, from providing meals to ensuring children's wellbeing and mental health to addressing child protection concerns, in addition to delivering the nationally agreed curriculum. In the wake of restrictions due to the coronavirus disease 2019 (COVID-19) pandemic, there have been calls for schools to be further expanded and reimagined as multi-opportunity communities.17 Yet children's lives also exist beyond the school gates. The institutionalised nature of childhood means that there are few pathways for children to actively take part in social and civic activities outside of school. When children do participate in social and civic activities, adults (usually parents or families with the necessary resources, and sometimes teachers) are needed to act as conduits. Making schools the primary, or only, focus of policy and programs for children in middle childhood is problematic, and restricts children's lives to a single institution outside of their family in ways that marginalise them from their broader communities. Moreover, the reliance on schools and education policy in delivering children's wellbeing ignores the range of influences beyond schools that shape children's lives.18

Community inclusion and participation has the potential to deliver positive outcomes for children's health and wellbeing and reduce the reliance on schools as the dominant or sole institution responsible for supporting children or providing intergenerational relationships.19 Each of the authors of this article has undertaken research with children that has consistently highlighted the extent to which children value social and intergenerational relationships.20 Children in the middle years have told us that their sense of wellbeing is strengthened when they feel respected and valued and when they believe that they have adult allies who work with them in solidarity.21 However, children also tell us that they are taught to be scared of adults, that adults downplay their concerns and worries, and, increasingly, that adults outside of their families and schools can be reluctant to build relationships with them.

The Australian Child Wellbeing Project found that family and friends consistently ranked as priorities for children in year 4, year 6 and year 8.22 School also ranked as important, but children were often somewhat ambivalent about it. Interestingly, almost one quarter of children in year 4 identified neighbourhood and community as important, but, by year 8, under 8% of children prioritised neighbourhood and community.22 In the Children and Communities in Australia project, children in middle childhood spoke of wanting to be part of and contribute to their communities, but often felt that there was no place for them.19 The exclusion of children in middle childhood from their communities might explain the decline in the importance children place on community or neighbourhood as they become older. Children who participated in the Children and Communities project also described feeling safer in their communities when they knew and trusted adults beyond their families.

Feeling respected and listened to is crucial to children's own sense of wellbeing, but, too often, children describe feeling ignored and marginalised. Social relationships are essential to children's sense of wellbeing. Strong and supportive relationships help children to develop a sense of competence and agency.23 Positive and trustworthy relationships are especially important for children who have experienced abuse or neglect and have complex needs.24

Ensuring the wellbeing of children in middle childhood requires us to consider their place and participation not only within the institution of school but beyond. It is also essential to recognise that children's opportunity to actively participate in their communities is shaped by their family's resources, socio-economic status, knowledge of what is on offer, and connections. The opportunity to participate in social and civic activities is not only narrow for children in middle childhood, it is also unequal.25 Children who live in disadvantaged communities have described feeling unwelcome in affluent communities and worry that they will be blamed if something goes wrong.26 Children from families under stress and who are fearful about judgment can be particularly isolated and describe feeling invisible.11

Ensuring the health and wellbeing of all children requires an understanding of the intersecting issues that shape and constrain their civic and social participation, from involvement in sport and recreational activities through to participation in community leadership roles. It requires active efforts to genuinely include and support children and families who are on the margins.

In developing policies to promote children's health and wellbeing, it is essential that middle childhood is made visible, and children in this age cohort are listened to. The current gap between ages six and 12 years is a significant shortcoming in the Australian policy landscape, but one that can be addressed by actively creating pathways for children in this age cohort to participate in and be part of their communities. In doing so, it is important to be focused on the contribution that safe and trustworthy social relationships make to children's sense of wellbeing. It is also essential that children are actively involved in determining the types of activities and connections needed to create child-inclusive societies that genuinely support children in middle childhood. As we reimagine children's place within our communities, and our policies, the role of school must remain crucial, but not to the exclusion of all else. Children in middle childhood should be visible, valued and included across community life; their health and wellbeing now and into the future depends on it.

No relevant disclosures.

Not commissioned; externally peer reviewed.

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童年中期的幸福、参与和联系。
确保儿童的健康和福祉是一项基本的社会目标,而要实现这一目标,最好的办法是让儿童与社区建立联系,有机会进行有意义的参与,并在家庭内外享受跨代的强有力的支持关系。这意味着对儿童和家庭个人及其社区进行投资。这也意味着要创建包容儿童的社区,积极为儿童提供参与各种社会和公民活动的途径。本文旨在强调中年期儿童的参与、健康和幸福之间的关系。中年期在这里被定义为 6 至 12 岁,与小学相对应。但儿童生活的特点不仅仅是上学。童年中期,儿童开始获得独立,同时与家庭保持紧密联系,但儿童的位置通常被理解为家庭或学校。将儿童的领域局限于家庭和学校,导致了童年的私有化,使他们被排斥在公共空间之外,对社会关系产生了有害影响1 。3 鉴于中年期儿童的重要性和儿童生活的复杂性,政策对儿童在学校和家庭之外的生活考虑不足。4 如果没有政策支持,对于那些家庭压力大或经济困难的儿童来说,参与社区活动尤其具有挑战性。首先,政策和服务需要更加适应中年儿童的需要。在澳大利亚,对幼儿期的重视是有道理的。然而,当我们创造条件让儿童及其家庭在生命早期茁壮成长时,我们需要注意不要在儿童步入童年中期时造成政策和服务悬崖。我们的第二个论点是,促进儿童健康和幸福的努力必须考虑如何建设包容儿童的社区,这些社区欢迎儿童,儿童可以以对他们有意义的方式积极参与其中。未来健康倒计时 2030》5 为我们提供了一个机会,以倡导儿童在童年中期的发展,并建设包容儿童的社区,为儿童创造参与社会和公民生活的途径。在澳大利亚和全球范围内,对幼年期的政策关注是有大量证据支持的。8 在过去十年中,政策重点已扩展到教育、健康和福利方面。2024 年 5 月推出的《国家幼儿战略》就是一个很好的例证,该战略倡导的愿景是 "澳大利亚所有儿童都能在幼儿时期茁壮成长。9 "澳大利亚早期发展普查"(Australian Early Development Census)在儿童发展的主要方面提供了有力的数据(https://www.aedc.gov.au);国家 "衡量重要事项框架"(Measuring What Matters Framework)(https://treasury.gov.au/policy-topics/measuring-what-matters)包含了一系列幼儿期指标,而且还设立了幼儿教育部长一职,所有这些都表明,确保儿童在最初的五年中得到良好支持的承诺日益坚定。然而,在澳大利亚和全球的政策中,却忽视了儿童中期在提供从幼年到青年的关键桥梁方面的作用。国家青年办公室 (https://www.youth.gov.au/) 的目标是将青年与政府联系起来,在制定政策和计划时创造真正参与和合作的机会。国家青年战略 Engage!(https://www.youth.gov.au/engage) 将青年定义为 12-24 岁的人。青年办公室指导委员会由 13-24 岁的青年组成,青年咨询小组由 16-25 岁的青年组成,就一系列政策问题提供建议。11 尽管这些发展值得欢迎,但它们也凸显了澳大利亚 6 岁至青春期早期的青少年在政策方面的巨大差距。中间环节缺失。
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来源期刊
Medical Journal of Australia
Medical Journal of Australia 医学-医学:内科
CiteScore
9.40
自引率
5.30%
发文量
410
审稿时长
3-8 weeks
期刊介绍: The Medical Journal of Australia (MJA) stands as Australia's foremost general medical journal, leading the dissemination of high-quality research and commentary to shape health policy and influence medical practices within the country. Under the leadership of Professor Virginia Barbour, the expert editorial team at MJA is dedicated to providing authors with a constructive and collaborative peer-review and publication process. Established in 1914, the MJA has evolved into a modern journal that upholds its founding values, maintaining a commitment to supporting the medical profession by delivering high-quality and pertinent information essential to medical practice.
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