chapter 28

Growth and development of a school age child of ages 6-12

• moves toward abstract thinking, seek appropriate of peers, teachers, and parents

• eye-hand coordination allows them to participate in oragnized sports

Physical growth

• ages 6-12 and growth average of: 2-5 inches per year.

• 7 lb per yearght and weight are similar.

• later school age years girls are taller and heavier than boys.

• both male and female want to be the same as their peers.

Physiologic changes

• maturation differs in boys and girls. will remain fairly consistent until later school age which is 10 years of age. Boys experience slowed growth in height and weight gain increases.

• preadolescence= rapid growth for girls.

• Neurologic: brain andskull grow slowly

• brain growth is complete by age 10

Respiratory system

• continue to mature with lung and alveoli development

• has fever respiratory infections

• repiratory decreases to 18-25 breaths per minute

• Abdominal breathing disapears now diaphragmatic breathing

• frontal sinuses are developed by 7 yo

• tonsils decrease in size but still remain larger than adolescents

Cardiovascular system

• BP increases 97-115/ 57-76 (age 6-9). 102-120/ 61-80 (10-11)

• Pulse decreases 75-118 (6-11)

• heat grows more slowly and smaller in size in relation to the body

GI system

• All 20 decidious teeth are lost during this time and replaced by 28-32 permanent teeth

• fewer GI upsets

• stomach capacity increases which permits longer retention

• calorie needs are less than early years.

• Appetite may increase

GU system

• Bladder capacity increases

• ages in years plus 2 oz

• 9years= 11oz bladder capacity

Physiologic changes cont.

• 2 years prior to the beginning of puberty

• development of secondary sexual characteristics

• 2 year difference between boys and girls

• important to educate about changes

Musculoskeltal system

• Growth leads to greater coordination and strengthl

• muscle are still immature and can be injured easily

• bones continue to ossify

Immune system

• lymphatic tissues continue to grow until age 9

• ImG A and G mature around age 10

• may have less infections however they may have more infections the first 1-2 years of school.

Motor skill development

• coordination balance and rhythym improve

• older school aged children may become awkward due to their bodies

• Physical skills in this age are similar to adults

• school age children should be encourage for sports

Fine motor skills

• myelinzation of the cns is reflected by refinement of fine motor skills.

• eye-hand coordination and balance improve.

• hand usage improves becoming steadier and independant

• *the child between 10-12 begings manipulative skills

• begin to play with musical instruemtntsents, which further enhances their fine motor skills and rhythm awareness.

• Night terrors should resolve by 8-10

Sensory development

• vision screening program in schools help identify, vision problems

• fequent eye problems

• amblypopiais a condition where the brain favors one eye over the other, leading to reduced vision in the affected eye. Early detection through screening can significantly improve treatment outcomes.

• striabismus which is misalignmen of eyes.

• striabismus is treated with eyepatches or corrective lenses.

• Sense of smell is mature and should be tested as well as touch.

Signs of vision problems

• eye rubbing, squinting

• avoiding reading

• frequent headaches

• holding reading materials close

• problems with depth perception or hand eye coordination

• sports related eye injuries and eye protection are important in this age group

communication and language development

• language skillls accelerate during childhood/ schoolage years

• reading and writing skills are important with increased exposure

• use more grammatical forms such as plurals and pronouns

• they are metalinguistic awereness and understanding of a language components, rules and functions

• begin to understand metaphors

• understand jokes because words can have double meaning.

Emotioinal and social development

• Tempernent -3 groups

• 1. easy and adaptable

• 2. slow to warm up

• 3. difficult and easily frustrated

• Not all children fit into this group, variations exists

• understanding the childs temperment can help, caregivers, teachers, and parents care for the child

Self esteem development

• Self esteem mirrors the childs sense of self worth. can be both positive and negative

• children to achieve goals of attachment

• they continually receive feedback from their authority figures and this is how they form opinion of self worth

• if school age children have matured autonomy and initiative, they will face the world with feelings of pride rather than shame

• SIgnificant adults in a childs life can maniipulate the enviorment to facilitae sucess. This success impacts the self esteem of the child/

  Body image-

• School age children are knowledgable about the human body but may have a different perception about what is normal.

• They are very interested in what their peers think'

Important for late school agers to feel accepted, begins at this age;

School age fears-

• Shift away from pretends fears but are now focused on real life events.

• Natural disasters, death, surgery, kidnapping, getting hurt

• may still fear the dark

• parents should listen to fears with sympathy and support

• coping strategies, relaxation techniques

Peer relationships influence independence from parents

• play an important role is developing self esteem, self wrath, and perception of self

• School age kids often associate with peers of the same sex

• Previosly only parents, teachers, and adults had influence but now they are influenced by their peers

• Begin to respect differing points of view

• may modify behavior to gain acceptance

Teacher and school influences

• school exerts a profound influence on the social development of the child - second only to parents/ family

• School means changes for the child and parent . Both need and confirm to new roles, someone after than mon and dad establishing rules. Can be different for both child and parent to adapt.

• Teachers must understand child development and be willing to guide learning.

• Teachers play a huge role in shaping the socialixatoin, self concept, and intellectual development of children.

Family Influence-

• School age kids begin to test parent and family values due to peer influence

• cultural influences must be kept in mind when accessing growth and development

• Cultural influences on growth and development

• School age children thrive on learning music, language, traditions, holidays, games, values, gender roles.

• Cultural implication must be considered to produce appropriate care.

Psychosocial development-

• Erikson -Industry vs. inferiority

• Developing their sense of self- worth

• - developing their sense of self worth

• trying new thing, accomplishments, learning all all contribute to building self- worth

• If expectations are set too high, child will develop sense of inferiorty.

Cognitive

• Piaget - concrete operational (ages 7-11)

• Learns by manipulating objects, no abstract thinking understands time,

• Principle of conservation- they can understand that matter does not change watter fill in

Moral development

• Kholdberg- conventional

• stage 3: interpersonal:

• Stage 4: law and order: age 10-12

• 7-10 year old wants to follow rules and wants to be a good person. 10-12 year old. the child can now identify if an action is good or bad based off of reason for the action.

• They begin to want to understand more about religion and are guided by the differnence between natural and supernatural

• Begining to understand to understand the difference between natural and supernatural

Promote Growth through play

• Both organized plus solitary play

• cooperative play

• participate in team play

• solitary games: cards, board games, video/ computer games, dolls, cars ect

• Team play: organized sports, tag, playground

• start collections, scrapbooks, keep a diary

• active play decreasing due to phone, computers, TV.

Promote learning

• school attendance plus learning very important

• Parent, teacher, peer relationships play a large role in how the child learns

Formal education

• must kids are exited to start school and make friends but they lose enthusian with starting school

Safety

Become more independent with age leading to self confidence and less fear. This can lead to reckless behavior and accidents.

* unintentional injuries are leading cause of death in children between 1-14 years of age

13 million children seek medical attention for non fatal injuries per year.

MVA is common cause of injury

School age children should sit in the rear seat, front seat is dangerous due to airbag (usually 13yo or older to ride up front)

school age children over 40 lbs 4-8yo should be in foward booster seat with shoulder belt

may graduate from a booster seat when seatbelt when seatbelt properly fits over hips anad shoulder. usually 4 ft 9 inches and 8-12yo

use child locks on rear doors.

Pedestrian safety

• 40,000 children are injured as pedestriants/ year and 456 pedestrian children are killed each year

• children under 10yo should not be unsupervised pedestrians

• Darting over into the street without looking is a common occurance

Bicycle and sport safety

• Bicyle, scooter, skateboarding, and inline skating nare common activties with injuries. Should wear pods and helmets

• helmet wearing has decreased head injuries by 60% ensure helmets fit properly and need to be refitted as growth occurs.

Fire safety

• very curious about five

• educate children what to do if they are on five, in a five year

Water safety

• teach how to swim

• wear life preserver until strong summer

• dont dive in shallow water

Child abuse

• Physical, sexual, or emotional.

• 3.5 million reports each year to child protective services

• teach children about inappropriate touch and to alert a trusteed adult if they have experienced abuse

• nurses are mandated reporters if abuse is suspected

Nutrition

• follow appropriate growth on growth charts.'

• needed calories decreases, appetite increasesas the body seeks to compensate for the energy deficit, leading to a natural increase in food intake.

• body fat composition increases happen earlier in girls than boys

• Diet preferences as preschooler continue in school age

Nutritional needs

For moderately active

• Boys 4-8= 1600cal/day

• 9-13= 1800-2200/day

• Girls= 1600cal/day

• 9-13= 1600-2000/day

Of these calries:

45-65% should come from carbs

10-30% from protein

25-35% from fat

Calcium

4-8yo = 1,000mg/ day

9-13yo = 1,300/ day

Fiber

4-8yo = 25 gm

9-13yo = 26-31 gm

Promoting sleep and rest

6-8yo - 12hr/night

8-10yo - 10-12/night

10-12yo - 9-10hr/night

young school age children may need an occasional brief nap.

night terrors or sleep walking may still occur in 6-8yo but usually gone by 8-10yo

Promoting healthy teeth plus gums

cavaties or caries are a leading chronic disease in US

42% of children ages 6-11 have cavities in primary teeth 21% in permanent teeth

should brush 2-3 times a day for 2-3 minutes with flouridated tooth paste.