The missing middle of childhood

ABSTRACT

Middle childhood, between six and twelve years, is a critical bridge between earlier childhood and adolescence with rapid physical and psychological transitions. Most of the world’s 2.6 billion young people, of which the middle childhood age group is a significant portion, live in low- and middle-income countries. Many live in environments that place them at high and growing risk for mental ill-health, injuries, and adoption of risky behaviours that often lead to non-communicable diseases in later years. Still, middle childhood, the ‘missing middle,’ is omitted from global health information systems, targeted policies, and strategies. The dearth of internationally comparable and standardised indicators on middle childhood in major international development agency databases hampers age-appropriate policy and programme development. Better understanding of the needs of this increasingly vulnerable population is critical. Middle childhood needs to be an explicit focus within child-focused research and implementation. Standardised, comprehensive, and relevant indicators are required to quantify the contribution of middle childhood to the global burden of disease and to facilitate interventions, monitoring, and evaluation, to ensure that all children flourish and thrive.

KEYWORDS:

• Missing middle
• childhood
• outcomes
• risk
• indicators
• standardization

Responsible Editor Stig wall

Responsible Editor Stig wall

Author contributions

MC, SB, MV conceptualised the initial study. MV wrote the first draft of the manuscript. All authors contributed equally providing critical feedback, reference sources, critical revisions of content, and verification of the information.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Paper context

Middle childhood is left out of global development goals, health information systems and policies and programmes. The ‘missing middle’ (children between the ages six-to-twelve) is exposed to risks and challenges that often result in poor mental health, overweight and obesity, including adverse outcomes later in life. Middle childhood is an optimal time in the life-course to promote health and wellbeing, but comprehensive and standardised data, age-appropriate policies, and programmes are lacking.

Notes

¹ Lower and upper age ranges vary between early, middle, and late childhood across data sources as discussed in this paper. Without standardized age ranges in the child growth and development literature, we have chosen the age span six to twelve years for middle childhood for the purpose of this discussion paper.

² Search results are based on the number of journal article titles that include the terms childhood; middle childhood; preadolescence; or adolescence..

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.