Nine-year-old child are fundamentally self-determined, self-motivated, and overall less warm toward the adults in their lives. Their brain is actively developing and becoming increasingly integrated every day. At this age, children are better coordinated, are likely to push their physical limits, and tire easily. At nine years old, children's gross and fine motor skills have greatly improved. By this age, children tend to have a clear understanding of sexual development, as well as what it means to be in a romantic relationship. Cognitive processes in this period are causal in nature and are best understood as black and white thinking. Nine-year-olds are better able to organize their thoughts and emotions into communications with those around them. Their strong desires for relationships play a large role in their social functioning. Child-centered activity play therapy (CCAPT) offers a balanced approach, allowing children the opportunity to use certain materials, such as crafts and games, to express themselves concretely.