Care of the school aged child

6-12 years

2.5 inches per year, 7lbs per year

Physical maturity doesn’t always match emotional and social maturity (will look older etc.), Expectations on behavior should match age not appearance, Girls & boys start off as similar in size, Girls hit growth spurts sooner, boys catch up later, Secondary sex characteristics begins to develop- can lead to embarrassment

Facial proportions change (more slender), Brain & skull slow growing, Brain is adult size by 10 years, Cognition improves

Respirations become diaphragmatic-less belly breathing, Respiratory rate decreases, Tonsil size increases, Less infections (immune system is stronger)

BP increases, Pulse rate decreases

Permenent teeth replace primary teeth, Less GI upset, Low caloric needs, Stomach capacity increases

Bladder capacity increases, Agde of child + 2oz, *Child age 8yrs + 2 oz = 10oz capacity (30mls/1oz) (10x30=300mls bladder capacity)

Gaining strength and more coordination, Bone ossification continues but not completely mineralized yet (still “bendier” than adults), (Team sports are getting more competitive)

2 years befor puberty: Development of secondary sex characteristics (pubic hair, breasts etc.), Parents/nurse/teachers to educate to help reduce anxiety r/t body changes, Rate of development either fast or slow can results in embarrassment

Adult levels of immunoglobulins (IgA &IgG) around age 10, IgA (in mucus & saliva), IgG (in blood serum), Results in less infections

Coordination, balance, and rhythm improve, May become akward as bodies are growing faster then able to compensate, *6-8 yrs enjoy gross motor activities such as bicycling,skating, and swimming, *8-10 yrs less restless, still high energy, activities more subdued and directed, greater rhythm and gracefulness of muscular mvmts allowing them to participate in physical activities that require longer more concentrated attention, *10-12yrs (girls pubescent years), energy levels remain high but are more controlled and focused. Physical skills in this age groups are similar to those of adults with strength and endurance increasing during adolescence

Hand usage improves, Eye-hand coordination and balance improve (hitting baseball or golf), Can write, print words, sew, or build models, Takes pride in activities requiring dexterity and fine motor skills, such as playing musical instruments

Industry versus inferiority stage, Interested in how things are made, Success on personal/social tasks, Outside activities, peer, learning, *Still associates with family values, *Learns by doing

Concrete operational stage, Learns by manipulating objects, No abstract thinking, Understands time

Conventional stage, Acts are wrong because you get punished, Behavior is right or wrong

Latency Focus on activities that develop social/cognitive skills

Hearing screening to identify hearing loss, Avoid exposure to excessive noise to prevent hearing loss

Children should have eye exam prior to the star of school, *Good vision is essential to the physical development and educational progression of school aged children, *Amblyopia (lazy eye), * Uncorrected or refractive errors (near-sightedness) or other eye defects, Malalignment of the eyes (Strabismus one eye being more nearsighted)

Vocabulary expands to 8,000 to 14,000 words, Cultrually specific words are used, More complex grammatical forms are used ( punctuation sentences), Development of metalinguistic awareness occurs (double meanings, puns), Metaphorss are beginning to be understood, May imitate family how family talks at home (including profanity)

Temperment -easy and abapatable, slow to warm, and difficult/ easily frustrated (can be diff combos), Self esteem (percievin body, acceptance act, talk positive about bodies), School age fears move from pretend things to real life things such as being hurt by others, natural disasters, ppl they love dying, etc., Peer relationships- helps child gain independence from parents tends to associate with same sec peers, Teacher and school influences play huge role in development etc., Family influences - may start testing parental or famil values even if they still respect them, Body image-related to how child perceives their body late school ages want acceptance

Should sit in backseat, Airbag off if they HAVE to sit in front seat, Look both ways, only cross at crosswalks (take earbuds out when crossing)

Should not swim unsupervised, Don’t run around pool, Don’t dive into shallow water

Helmet recommended (not allowed) (can ⬇️head injury by over 20%) (should be well fitting, not cover eye or ears), Padding, protective equipment, Ride on sidewalk

Fire escape plan; smoke detectors (2nd story home fold out ladders etc.), Cook with adult supervision, Don’t touch down wires or power lines!, Don’t play with matches of fireworks, Also teach danger of guns, and drugs

Child maltreatment includes physical abuse, sexual abuse, emotional abuse and neglect, A hx of childhood abuse is associated with dev, of anxiety and depressive disorders, suicidal ideation and attempts, and alcohol and drug use

Are you afraid of anyone at home?, Who could you tell if someone hurt you or touched you in a way that made you uncomfortable?, Has anyone hurt you or touched you in that way?

Are you afraid of anyone at home?, Do you ever feel like you may hit or hurt your child when frustrated?

Check night and weight compared to previous measurements, assess BMI for age (dont do until at least 2 yrs old), Nutrition history including 24hr recall of what was a consumed, Inquire about family meals and social aspects of seating including who preparers the meals (get answers from parent and child), Identify any knowledge gaps relating to nutrition, Needs vary based on age, gender, and activity level, Needed calories decrease while appetite increases -increased body fat occurs earlier in girls than boys - diet preference est. in preschool years persist, Focus on Whole Foods and less processed foods

Cardiovascular fitness, Weight control, Emotional tension release, Development of leadership and social skills, Learns value of playing by the rules, Organized cooperative activities (team sports) & solidarity activities (crafts, games)

9-12 hrs of sleep per night, Bedtine routine still important, Encourage reading, Night terrors and sleep walking resolved by 10 yrs

Brush 2-3 times/day, 2-3 minutes with florinated toothpasate, Need help/supervsion with dental hygiene until about 8 yrs, Bruxism while asleep (teeth grinding), Orthodontist evaluation (oral hygiene very important with braces)

Should be aware of cause and effect of behavior, Type and amount of discipline depends on many factors, Postivive acknowledgement of progress, Avoid belittling or insulting child, Natural consequences- allow child to learn results of their actions (Throws toy out of car can no longer play with toy), Logical consequences- if child does not put their bike away cannot play with the bike for rest of the day