In middle childhood, where academic issues and concerns dominate considerations of an individual's school performance, the importance of peer relations and social development is sometimes overlooked. Moreover, although children may be keenly aware of peer problems, they often attempt to conceal them out of embarrassment. The result is that difficulties are recognized and treated only when the behavioral complications of social inability are severe or deviant enough to attract attention. At this point, parents may feel either helpless and ineffective at promoting their children's social development, or demoralized and angered by the resultant behavioral problems.
THE SOCIAL SCENE
The Tyranny of the Peer Group
Once children have formed primary relationships with family, they begin to establish social ties with peers. Peers are of comparable age and development, yet have different backgrounds and experiences. Although the pivotal role that peers play in childhood socialization has been a focus of increasing research over the last decade, its importance has been appreciated in explicit and often agonizing detail by generations of school children. The quests for friendship, popularity, and the avoidance of humiliation at all costs are relentless campaigns, which may well take precedence over academic stardom or pleasing parents.
Children feel enormous pressure to define themselves by being like others their age, and the drive toward conformity becomes a nearly tyrannical force. In junior high school social pressure may reach its utmost intensity. Many early adolescents feel self-conscious and vulnerable, are keenly aware of stereotyped gender rolçs, and are heavily preoccupied with the need not to deviate from narrow norms. This period also encompasses the widest variation in cognitive and physical maturation, adding the irony of developmental heterogeneity at the very time youngsters are seeking uniformity.
Figure 1. A classification of deviant patterns of social development in children. This conceptual model of oversocialization and undersocialization is based on the Diagnostic and Statistical Manual of Mental Disorders III.
Certain settings (such as the bus, cafeteria, gymnasium, and shopping malls) provide the backdrop for fierce and telling social transactions. Being labeled or called names is an ever present threat. Immunity from unkind appellations is a sign of social success. Contemporary derogatory terminology includes such words as wimp, airhead, and mental case. On the other hand, to be called awesome or radical is gratifying. Interestingly, the classroom is one of the most protected arenas for peer relationships.
This characterization of the social milieu ignores the nonconformist who prefers a more inner-directed social life. The abilities of some relatively autonomous children to maintain their individuality without experiencing undue social retribution must be among the more laudable accomplishments of middle childhood.
Gang and Clique Formation
The drive for acceptance and the fear of rejection foster the development of gangs and cliques, which can offer members security while enhancing reputations. Within the gang, risk taking and courage may be valued markers of an apparent emancipation. Those who have never managed to please adults may now find an approving constituency by engaging in antisocial behavior.
Influence of the Opposite Sex
Preadolescence as a period of sexual latency has been overstressed. The beginning awareness of the self as a sexual being, and of others as potential sexual partners, is very real for many children. Best friends are selected across sex lines in 20% of fifth grade children. ' The majority of sixth grade boys and girls prefer a companion of the opposite sex to one of the same sex when taking a walk or going to a movie. Recent trends toward the commercial exploitation of children and increasing exposure to media replete with implicit sexual messages also favor an earlier sexual awakening. Children are required to make inroads with the opposite sex while accommodating the social demands of their same-sex peers. Having to play to two audiences simultaneously adds a challenging dimension to the social life of the school child.
THE PROCESS OF SOCIALIZATION
Socialization is the process by which children become participants in society: conforming to societal rules, deriving pleasure from interpersonal relationships, and realizing their potential in a personally satisfying and socially contributory way. Like any developmental process, socialization may be arrested, delayed, or it may fail to occur. Many delays can be reversed, and missed opportunities may be presented again. In some circumstances, a child may prove malleable and resilient in overcoming adversity; in others, discrete psychiatric disorders may emerge in childhood and later life in which failure of socialization is a major component.2 These disorders may be conceptually grouped into disorders of undersocialization and those of oversocialization, although there is debate about the limitations of such a nosologic system (Figure 1).
Psychosocial Factors and the Facilitating Environment
Early physical contact between a mother and baby facilitates the development of an infant's primary relationships and may lead to substantial gains in childhood social competence. Marital discord, large family size, parental criminality, and alcoholism put children at risk of disturbance of socialization. Geographic and socioeconomic factors affect the process of socialization. The rates of conduct and emotional disorders in the inner city of London were twice those of the Isle of Wight. 5 They were not due to ethnic effects, migration, or poverty itself, but rather to family stress, a frequent accompaniment of poverty in urban areas. Even within the inner city there are different regions and streets that appear to confer risk or protection on children. Schools also are important variables: those with a pleasant and safe environment, an emphasis on academics and student responsibility, and teachers who serve as good role models enjoy better attendance, educational achievement, and student behavior.
Biologic Factors Affecting Socialization
Biologic Factors and the Receptive Child
Clinical observation points to a potent inborn contribution to a child's social abilities (Table 1). It is common to find as siblings a socially rejected child and a social butterfly. There is evidence that certain enduring temperamental traits are genetically determined. Chess4 has described the interaction between a child's temperament and the parents as the "goodness of fit." A good fit may lead to expanded social competence, whereas a poor fit may impede optimal socialization. Goodness of fit may change over time, and this interactional model correctly predicts that socialization does not hinge in a deterministic way on early childhood.
Variations in neurodevelopmental function may affect a child's receptivity to socialization and predispose to social failure. Although many students experience tremendous difficulty academically and impressive success socially, the coexistence of learning problems and social failure has been well described.5 Linguistic proficiency has been shown to relate to socialization. Students with receptive language weaknesses often are less responsive to verbal feedback cues and have trouble drawing social inferences. Expressive language deficiencies lead to reduced abilities to initiate and sustain conversations and to convey feelings and information. More intrusive and competitive statements are made, serving to alienate the student and erode social standing. Children with attention deficits are also prone to social difficulties: they may have trouble reading the social scene and make impulsive social errors. Some children are demanding, uncompromising, and insatiable. Others display adequate reciprocity but jeopardize their reputations by capriciously changing the focus of communication.
Other biologic influences on socialization are less commonly encountered. Autism and other pervasive developmental disorders are accompanied by profound disturbances in social interaction. Visually impaired children encounter socialization difficulties directly related to their experiences of blindness.6 Children recovering from closed head injuries may experience subtle language impairments that hinder social communication. Children with brain disorders such as epilepsy are at increased risk of psychiatric disorder, including failures of socialization, although the mechanisms are uncertain.7
Protective Factors and Invulnerability
A sizable proportion of children with socioeconomic or biologic risk factors of socialization failure are remarkably well adjusted. What contributes to the development of the so-called invulnerable child? Early work in this growing field of research indicates that certain protective factors are of great significance (Figure 2). These include a favorable temperament, compensating experiences outside the home, and the availability of long term relationships with helping adults.
POPULARITY AND UNPOPULARITY
Peer status is the degree to which an individual child is liked or disliked by peer group members. Research on peer groups has been conducted primarily in school sertings, using sociometric methods that typically classify children into four subgroups: Popular children are acceptable, sought after, and respected by their peers; controversial children are highly liked by some and highly disliked by others; neglected children are relatively inconspicuous, and nobody seems to know them very well; rejected children are ostracized from the peer group.
Preschoolers develop stable perceptions about the "likeability" of their peers. Similar status differentiation is also found in grade school peer groups and emerges soon after a group is formed. 8 During middle childhood, children's peer reputations remain relatively stable, especially those of rejected children. Longitudinal studies have shown that one third of those children rejected by their peers in third grade had the same status five years later. This does not appear to be an accident of the particular group's composition because the social problems of rejected children quickly recur when they are placed in new groups with unfamiliar peers. Interestingly, neglected children are able to become more socially outgoing when they are placed in new, small group situations, and their peer status is more flexible. This observation may have some bearing on the landmark longitudinal study by Morris,9 in which shy, withdrawn children were followed into adulthood and fully two thirds were found to be well adjusted, self-supporting, and stable.
Social Competencies Associated with Popularity
The contrasts between socially successful and unsuccessful children have been scrutinized in an attempt to discern the behavioral differences underlying popularity. ,0 Children who are rejected or neglected do not lack social initiative but are more likely to be rebuffed. Rejected boys often make aggressive social approaches and engage in disruptive and antisocial behavior. Rejected children tend to have younger friends more often than do popular or neglected children.
Figure 2. The stepwise nature of "invulnerability" and important protective factors.
Controversial children interact considerably with their peers and they display significant interpersonal skill. They engage in the greatest number of prosocial behaviors but also have a high level of aggressive play, noise making, and exclusion of peers. They are perceived by their peers as unpredictable.
Popular boys initiate contacts less frequently and refrain from aggression. Their interactions last longer and have more positive outcomes. They are perceived by their peers as "good leaders who share things." Popular children also tend to be more physically attractive. However, their appearance alone does not account for their social success; they actually have better social skills. It is important to note that popularity often carries with it a good deal of stress. Reputations have to be defended and many popular children are keenly aware that their highly visible bubbles may burst.
The Critical Popularity Subskills
A series of subskills that children employ with varying degrees of success are felt to influence their popularity substantially.11
Relevance. Socially competent children entering a social situation are able to perceive and interpret its tone and drift, thus gaining entry while maintaining the existing flow.
Responsiveness. Popular children are skilled at making their peers feel wanted, recognized, and valued during their interactions.
Timing and staging. Popular children understand that formation of relationships requires discretion and careful pacing. They do not take liberties too early in a relationship.
Feedback cues. Popular children are better able to perceive and more accurately interpret verbal and nonverbal feedback. They therefore know when they have said the wrong thing and can employ recuperative strategies.
Conflict resolution. Conflict is an unavoidable component of social interaction. Popular children are adept at resolving conflict without aggression, calling into play a number of adaptive social strategies such as humor, distraction, and negotiation.
Pragmatic skiïs. Popular children are more skilled in modulating their language according to their audience and in taking the perspective of the listener. They seem to convey their feelings more accurately and are less likely to misinterpret the feelings of others. They also are equipped with a sophisticated "trait vocabulary," which enables them to use "in" words like nerd, wimp, and weird with great precision.
Social prediction. Some children have a strong sense of how others will react to their statements and behaviors and are able to employ more strategy and planning in their interactions.
Friendship and Social Cognitive Development
Awareness of image. Popular children know how to market themselves. They are competent cultural anthropologists and understand the behaviors and appearances that are admired and the values that are respected by their peers.
In contrast to peer status, friendships refer to specific relationships between two children. Children come to see and know themselves through the eyes of their friends. Friends provide emotional support in times of need. Relationships with childhood friends serve as precursors for later relationships.
Onset and Stability of Friendships
The friendships of grade school children are more enduring than those of preschoolers. In a longitudinal study of friendships among fourth and eighth grade students,12 two thirds of the friendships remained stable over the course of the school year. Those that were perceived as intimate by the two friends at the start of the study were especially likely to endure. Not surprisingly, friends are commonly of similar age and peer status. Friendships between children of different races are common during early childhood but tend to decline in preadolescence.
Observations of the process of friendship formation reveal a set of social skills that are related to the popularity subskills. However, it is common to find unpopular children who enjoy rich and lasting friendships. The key determinants of friendship formation include the establishment of a common ground between individuals, the exchange of relevant information, and the clarity and connectedness of verbal and nonverbal communication. In older children especially, self-disclosure of feelings contributes to the bond between friends.
The Meanings of Friendship
Most young children's perceptions of friendship revolve around the sharing of toys, materials, and enjoyable activities. To older children friendship takes cm new meanings. The sharing of private thoughts and feelings becomes increasingly important, especially (in this culture) for girls. Children value mutual respecr and loyalty and begin to develop an understanding of the interdependence of friends. Younger friends, especially boys, are apt to engage in competition with friends; older children are more inclined to seek and achieve equality with their friends by sharing.
The Developmental Underpinnings of Friendship
What does the study of friendships tell us about the cognitive development of children? Selman" described the development of social perspective-taking in childhood, from the egocentrism of early childhood through a period of increasing ability to take the perspectives of friends and to see oneself through the eyes of others. Adolescence sees further growth in the abilities to view one's friendships more objectively and to evaluate them in the context of one's community and society (Table 2).
Parallel with this aspect of development, there is a growth in the child's understanding of others. Kindergarten children tend to have a nonjudgmental view of peers and think that other children would behave in a given situation just as they themselves would behave. In contrast to this "situationalist" disposition, older children are highly judgmental of others and tend to think that behavior of others is determined by fixed attributes. With such a "dispositionalist" outlook, people are viewed as unchanging and predictable, and everyone is rigidly categorized and labeled. During adolescence, the situational ist perspective undergoes a rebirth, as students come to see that individuals have good points and bad points and that their behavior changes under different circumstances.
Stages of Social Heterosexual Maturation
Like the development of perspective taking and understanding of others, the acquisition of moral values has a significant impact on children's relationships. Kohlberg14 denned and tested a series of moral stages analogous to the cognitive developmental sequences of Piaget. There has been controversy over Kohlberg's model. Coles,15 in his insightful analysis of the morality and motivations of children in stressful situations, describes a more complex moral sensibility in children.
Love and Sex in Childhood
In preadolescence, youngsters begin to develop "crushes" on persons outside the family expressed by roughhouse love play, writing notes, or walking home together, if the other person responds to this attention, the two may enter into the first of a series of close relationships. An orderly progression of heterosexual maturation is discernible (Table 3). The most advanced stage for preadolescence is usually dating. Almost half of 10- to 12-year-old children report having been in love, and 15% of this latter group have actually been out on a date. These relationships provide learning experiences that can be exciting, painful, and embarrassing, and undoubtedly influence later attitudes to love and sex.
Loneliness in Children
Sociometnc studies of popularity are an indirect measure of a child's own perceptions of peer relationships. Children with poor peer relations are usually identified by teacher ratings or observations. When children are asked to complete a self-reported scale of loneliness, there is a modest relationship to the sociometric measure.16 One in 10 normal children reports feeling lonely; undoubtedly, there are others who feel lonely but deny these feelings.
IMPLICATIONS FOR PEDIATRIC CARE
Pediatricians can serve an important preventive function in assisting parents in their efforts to understand their children's social development. This may take the form of anticipatory guidance, where the pediatrician helps to increase parents' awareness of their children's social lives and encourages them to monitor friendships and peer interactions. By exploring the social arena, first generally and then specifically, it is usually possible to gather insights into the child's perceptions and feelings. Pediatricians may also play an important role in interventions designed to help children experiencing social difficulties. Advising parents of the need for professional assistance is an important first step toward further treatment. A knowledge of the range of services in the community is essential. Potential collaborators include teachers, school counselors, school psychologists, clinical psychologists, and child psychiatrists. Professionals running groups designed to promote social skills and peer relationships may be especially helpful. ,7 Therapeutic successes in this area of child developmental dysfunction may be among the most gratifying in a clinician's experience.
Table 3 was adapted from Broderick and Fowler.1
The author thanks Elaine Goolsby for her suggestions in the preparation of this manuscript, and Ann Teague for her secretarial assistance.
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Biologic Factors Affecting Socialization
Friendship and Social Cognitive Development
Stages of Social Heterosexual Maturation