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Meet the Washington’s Case Study: Ava Washington

Ava Washington lives in Riverbend City with her parents and two older sisters (Emma, 13, and Kayla, 16 yrs.). She also had a great-grandmother. Tyler, her 23-year-old elder brother, is also a married father of two children. Although they were close when Tyler lived at home, their relationship changed once he started his family. Despite her profound love for her family, Ava may sometimes feel alienated since she is the youngest. Tyler’s attention has naturally shifted to his children, and Ava is having difficulty connecting with her sisters. Kayla’s connection with Emma is fragile since she often disagrees with her and ignores Ava. Despite everything, Ava still cares about her family. Ava spends her free time with her close friends and family. However, she has many interactions with her family and friends. In contrast to how she feels connected and unified with her friends, she has conflict and feelings of exclusion at home. However, Ava navigates her 9-year-old environment with ease, balancing playing alone and socializing with her family and friends.

Middle Childhood

Middle childhood, also known as “the years seven to eleven,” is marked by significant changes in the body and brain. Surprisingly, the body’s rate of development decreases during this period, but the percentage of muscle and fat in the body increases (Matthews, 2021). A child’s brain achieves total capacity at this age, making brain development an essential element of this era. While white matter continues to grow, the bulk of gray matter, which is responsible for information processing, is developed during the middle years of childhood. By age six, a child’s brain has practically reached its total capacity, but there are still numerous developmental milestones to accomplish. In addition to physical changes, middle childhood is marked by significant behavioral and social skill changes. Disparities between the sexes at this critical age emerge regarding social interaction, cognitive function, and physical development (Matthews, 2021). Even if they have not reached sexual maturity, middle-aged children are less dependent on their parents for survival. Establishing unique personal characteristics and a growing sense of autonomy provide the framework for the succeeding stages of development.

Theories and Concepts

The Concrete Operational Stage, the third stage in Piaget’s developmental theory, occurs most often between the ages of seven and eleven. Children in this developmental period demonstrate logical thinking, especially when given practical activities such as completing arithmetic problems (Rashid et al., 2020). Many people in this developmental period, like Ava, have activities like item sorting based on similar traits and seriation exercises. Despite its benefits, more study has shown certain flaws in Piaget’s hypothesis. Despite Piaget’s prediction, children only sometimes acquire all aspects of the concrete operational stage simultaneously. For example, the ability to seriate may not emerge simultaneously with the ability to classify. Education and culture are acknowledged and have a much more significant impact on a child’s development than Piaget (Rashid et al., 2020).

The ability to stand back and see things from the perspectives of others often begins to emerge in middle childhood, between the ages of seven and eleven. In social cognition, “perspective-taking” refers to putting oneself in another person’s shoes and attempting to understand their ideas and feelings. During this stage of development, children learn to manage their thoughts and analyze things from several perspectives (Rashid et al., 2020). Ava’s self-description, interpersonal insights, and assessment of her classmates’ impressions show that she is developing excellent perspective-taking abilities. This developmental milestone shows how empathy and awareness of other people’s viewpoints emerge in individuals throughout this period of cognitive development.

While Piaget’s Concrete Operational Stage provides invaluable insights, a recent study has shown more nuanced components. Piaget overestimated the situation’s complexity; children do not all learn specific operational duties at the same rate. It is possible that abilities such as learning to seriate and categorize objects do not grow simultaneously (Rashid et al., 2020). Education and culture impact a child’s development more than Piaget initially observed. As a result, Ava’s increasing self-consciousness, social skills, and understanding of how her classmates see her all show that the middle childhood years are essential for developing perspective-taking abilities. This nuanced viewpoint exemplifies the complexities of cognitive development at this critical moment.

Summary and conclusion

Despite their importance, the middle years of childhood are typically disregarded. Ava is reaching developmental milestones and exhibiting evidence of normal brain development, but more therapy sessions may help her feel better about herself and her interactions with others. Ensure Ava understands the importance of confidentiality and HIPAA requirements in future interactions. To feel comfortable opening up to her therapist, Ava must understand that everything she says in therapy is private unless she gets her therapist’s permission to share it with another person. It is consistent with the APA Code of Ethics (Fisher, 2021). Ava’s disclosure of information may imperil herself or others if this conditional secrecy agreement is reached.

In later therapy sessions, we may go further into Ava’s self-description and the dynamics of her relationships to identify any underlying issues that might benefit from treatment. It is critical to provide Ava with a secure and private location to visit throughout her transition from early childhood to middle childhood, a time characterized by considerable emotional, social, and cognitive growth. Ava may gain confidence in therapy by learning about the APA’s ethical values and creating a safe space to express herself and learn more about herself. This strategy respects the ethical constraints guiding the therapist-client relationship while prioritizing Ava’s well-being.


Fisher, C. B. (2021). Decoding the ethics code: A practical guide for psychologists. Sage Publications.

Matthews, G. B. (2021). A philosophy of childhood. In Gareth B. Matthews, The Child’s Philosopher (pp. 232–247). Routledge.

Rashid, S. A. R. A., Bukhari, F. A. H. E. E. M., & Shakir, K. H. U. R. R. A. M. (2020). Application of Social Power Theory to Elucidate Passive Parental Power and Child Influence in Family Purchase Decisions–An Empirical Study on Piaget’s Concrete Operational Stage. International Review of Social Sciences8, 12.’s_concrete_operational_stage/links/602d608f92851c4ed57bebe9/Application-of-Social-Power-Theory-to-elucidate-Passive-Parental-power-and-child-influence-in-Family-Purchase-Decisions-An-Empirical-Study-on-Paigets-concrete-operational-stage.pdf


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