0:07 this week we'll learn what children's development looks like between the ages of three and eight or basically between toddlerhood and the point in time when pretty much all children around the world are in primary school so as much change as we saw from prenatal to age three there are even more dramatic changes from toddlerhood to preschool age through early primary school age these will cover areas of physical development cognitive and executive function development language and literacy and socio-emotional development before we dive into the first topic which is physical development let's start by seeing what kids can do by the end of early childhood this is some footage of children from the solomon
0:54 islands of the south pacific in a center sponsored by save the children and let's notice what children can do by preschool age children can run around and dance they can also sit down immediately when asked to by the teacher to transition to the next activity they can understand numbers and words speak sentences they can manipulate small toys they can represent one thing by another children can build a truck for example from blocks something's not in the video that kids can do by preschool age include understanding the beliefs and intentions of others feeling not only empathy but also guilt and shifting flexibly between
1:39 different sets of cognitive rules such as switching from one language to another and yes by preschool age children can be fully bilingual so we'll talk about all of these changes and more this week on the other hand the video also showed that there are things that young children can't do they can't always walk eight kilometers to a school or cross a river to get to it and so they're still small physically and they're young cognitively for example they might understand some rules of grammar but not yet be able to communicate the rules to you they may understand cause and effect but they may mix it up a bit for example a friend of mine just told me about her four-year-old daughter who believes that when people die they become statues
2:24 because she saw on tv how holidays celebrated dead people by showing their statues so she felt that when her dog died that the dog was going to turn into a statue something that older children probably wouldn't believe let's turn to physical development our themes here will be fine and gross motor skills issues with growth particularly height and weight and global patterns around the under five mortality as children grow in the preschool years they're able to engage in increasingly sophisticated fine motor skills these are things like working with your fingers manipulating small objects holding a pencil or a pen very fine hand eye coordination we see this in the arts children's
3:11 growing abilities to paint to play musical instruments we also see that their gross motor skills have moved pretty far beyond the transitions from crawling to walking that we saw in the infant years and these include balancing throwing objects and catching objects kicking hopping skipping jumping these kinds of gross motor skills that are really the beginning of why young kids can start with certainly young versions of certain kinds of sports and activities we should be concerned with the problems with growth and physical development in too many areas of the world so in low and middle income countries there are continued
3:57 high rates of stunting in malnutrition past the first thousand days that we heard about into this period between the ages of three and eight both stunting and malnutrition present problems for life course health outcomes as well as learning the good news is that something declined quite a lot between 1990 and 2010. in 1990 253 million children were stunted in those 20 years there was a one-third decline in the numbers to 167 million in 2010 and simultaneously over those two decades as many countries economies grew we saw growing problems of overweight and
4:42 childhood obesity more in the middle-income countries than in the low-income countries and this increased from about 28 million children who were overweight and or obese in 1990 to 41 million in 2010 and that's nearly a 50 increase you can notice that of course the number is still much smaller than the 167 million afflicted by stunting so the greater problem currently in the world is around malnutrition what about rates of mortality by age five here we have good news and still a remaining challenge so under five deaths worldwide have declined by 50 percent from 12.7 million in 1990 to 6.3 million in 2013.
5:29 so despite population growth seventeen thousand fewer children are dying per day and yet an equal number seventeen thousand children under the age of five are dying every day even today the global annual rate of reduction of underfly mortality has also accelerated and so this is good news for global goal setting because it shows us evidence that the millennium development goals really may have made a large difference in this reduction so if we compare the rate of reduction in under five mortality between 1990 and 1995 which is about 1.2 percent a year that rate of reduction accelerated to 4 per year by 2005 to 2013.
6:14 the millennium development goal was to reduce by two-thirds the under-five mortality rate in every single country in the world and this graph shows that in certain areas that goal was achieved which is really quite remarkable in the latin america and caribbean region in the northern africa region and in the east asia region the mdg for under five mortality was achieved it was also achieved in the rich countries which had very low rates of under five mortality but they reduced them further by two-thirds other regions did not make so much progress in particular sub-saharan africa and oceania made less progress than other regions if we turn to where the concentration of under five mortality is at the national level we
7:01 can see that about half of these deaths occur in just five countries in india nigeria pakistan the democratic republic of congo and china and in fact just two of these countries india and nigeria represent together one third of the global burden these problems of under five mortality are concentrated in certain regions of the world and in certain countries of the world if we turn to the causes of death in under five mortality in lower middle income countries chief immediate causes are the major health problems of early childhood so these are pneumonia birth asphyxia diarrhea and malaria and those themselves are predicted by a
7:48 set of social determinants which are really the contexts of children's lives and communities and these include household poverty community level poverty access to water and sanitation and hygiene facilities and community health services from these causes of death and social determinants we can see that several kinds of policies might reduce under five mortality and they do include water and sanitation programs social protection policies which would reduce extreme poverty strengthening health systems and the community health worker workforce and integrating health and nutrition services you see how public health data on the social determinants
8:33 of major problems like undefined mortality lead us towards the kinds of solutions and policies that might make a difference what are the kinds of conditions that need to be in place for those kinds of policies well cross-country case studies from around the world show that political commitment matters and that's where global goal setting like the sustainable development goals can make a difference but we also need greater resources and finance to address the causes and social determinants of mortality so to address extreme poverty to bring water and sanitation for all especially the most vulnerable communities finally we need research and evidence we need monitoring systems that can link accurate data at the national level for healthcare access for access to water and sanitation
9:20 accurate data on poverty and economic disadvantage so those give us some directions for us to move on to reduce under five mortality to ensure that children can achieve the kinds of fine and gross motor skills so they can thrive in their physical development
