School Age

School Age  Assessment:  Physical Growth and Development  They grow slowly but steadily  Annual average weight gain is approximately 3 to 5 lb; the increase in height is 1 to 2 inches  Posture becomes more erect  By age 10, brain growth is complete so fine motor coordination becomes refined  The eye globe reaches its final shape so that an adult vision is achieved  If the eruption of permanent teeth and growth of the jaw do not correlate with the final head growth, malocclusion with teeth misalignment may result  IgG and IgA reach adult levels and lymphatic tissue continues to grow up until about age 9  Left ventricle of the heart enlarges to be strong enough to pump blood to the growing body  Time of the onset for PUBERTY  Changes in physical appearance lead to problems and worries for both children and their parents

 Deciduous teeth are permanent teeth erupt

ruptured

and

 At age 6, children start to endlessly jump, tumble, skip and hop (Gross Motor Dev’t)  They have enough coordination to walk a straight line  At age 6 also, they can easily tie their shoelaces (Fine Motor Dev’t)  Cognitive  Period from 5-7 years is a transitional stage when children undergo a shift from the preoperational thought they used as preschoolers to concrete operational thought or the ability to reason through any problem that they can actually visualize  Several new concepts learned by schoolage children includes: •

Decentering- ability to project self into other people’s situation

•

Accommodation- ability to adapt thought to fit what is perceived

•

Conservation- ability to appreciate that a change in shape does not necessarily mean a change in size

•

Class inclusion- ability to understand that objects can belong to more than one classification

 Personality and Temperament

 They enter the stage of preconventional reasoning  They concentrate on niceness or fairness

 Much of a child’s talk is concerned with these concepts as he or she practices them and shows them off for family and friends

 The distinction between right and wrong becomes more important to them

 By age 9, they discover dirty jokes and share them to friends or try to understand those shared by adults

 They are rule-oriented, when they pray they expect their God to follow rules also

 By 12 years, a sense of humor is apparent

 Because they are still limited in their ability to understand other’s views, they may interpret something as being right because it is good for them, not because it is right for humanity as a whole  Communication  They talk in full sentences, using language easily and with meaning  They no longer sound as though talking is an experiment but appear to have incorporated language easily  They still define objects by their use: a key is to unlock a door; a fork is to eat with  Most of them can tell the time in hours, but they may have trouble with concepts such as half past and quarter to, especially with the prevalence of digital clocks  They know the months of the year and can name the months in which holidays fall.

 Emotional  Developmental Inferiority

task:

Industry

versus

 They tend to learn a sense of industry and accomplishment-learning how to do things well  They have the ability to trust others and with a sense of respect of their own worth  They can accomplish small task independently because they want to be independent  They should have mimicked adult roles and had the opportunity to explore at preschool or other social environments  They should have learned to share, to have discovered that learning is fun and an adventure, and to have learned that doing things is more important and more rewarding than just watching things done  Play  Play continues to be rough; however, when children discover reading as an enjoyable

activity that opens doors to other worlds, they will begin to spend time with books  By age 7, they require more props for play than they were younger  They also develop a an interest in collecting items e.g. baseball cards, dolls, rocks, marbles  8-year olds like table games but hate to lose, so they tend to avoid competitive games  By age 9, they enter a phase of reading comic books, they play hard  They begin music lessons for children  At 10-years old, they spend most of their time playing handheld or television remote games; they tend to have interest in rules and fairness  By 11 and 12 years old, they enjoy dancing to popular music and playing table games  Diagnosis:  Health-seeking behaviors related school age growth and development

to

normal

 Readiness for enhanced parenting related to improved family living conditions  Anxiety related to slow growth pattern of child  Risk for injury related to deficient parental knowledge about safety precautions for a schoolaged child

 Planning and Implementation for Health

Promotion:  School Age Safety  They are ready on their own without direct adult supervision  By age 8 and 9, many children stay by themselves after school  As with adults, accidents tend to occur when children are under stress  Sexual abuse is an unfortunate and all-too common hazard for children  Nutrition Health  Most school age children have good appetites, although any meal is influenced by the day’s activities.  School age children need breakfast to provide enough energy to get them through active mornings at school  Most children are hungry when they arrive home, so snacks should be available  As part of fostering industry, school-aged children usually enjoy helping meals  It is important that the increasing energy requirements that come with this age are met daily with foods of high nutritional value  School-Age child in Daily Activities

 With life centered on school activities and friends, the school-age child needs parental guidance for most daily activities  Promoting Healthy Family Functioning  At 6 years of age, most children have passed through a preschool phase of attraction for the parent of the opposite sex and identify again with the parent of the same sex  To their parent’s annoyance, many 6-yearolds often quote their teacher as the final authority in all subjects  Parents often must be reminded that even the simplest tasks of everyday life require repeated practice before they can be accomplished well  Parental

Concerns development:

related

to

normal

 Dental Caries  School aged children usually have cavities due to excess eating of sweets.  It is important to teach them the proper way of brushing their teeth, also, making the brushing a fun experience, three times a day! Some children may have to wear special dental correctors such as braces, with special types and ways to brush, be sure to teach the child the right way to brush them.

 Malocclusion  While about 90 percent of school-aged children have some degree of malocclusion, only about 10 to 15 percent of these have severe malocclusion that requires treatment.  The upper jaw in children matures rapidly in early childhood along with skull growth, the lower jaw forms more slowly, which forces teeth to make a prolonged series of changes until they reach their final adult alignment and position  Children who suck their thumbs or fingers beyond the age of 5 have an increased chance of developing malocclusion. Children with a very small space between their primary teeth (baby teeth) are at risk for having problems with malocclusion when their permanent teeth appear, because the permanent teeth are larger and require more space.  Good teeth occlusion is necessary for optimal formation of teeth, health of the supporting tissue, optimal speech development, and what most people view as a pleasant physical appearance for high self-esteem  Language Development  They talk in full sentences, using language easily and with meaning

 They no longer sound as though talking is an experiment but appear to have incorporated language easily  They still define objects by their use: a key is to unlock a door; a fork is to eat with  At age 6, they have limited ability to understand complicated language structures. From ages 6 to 10, children gradually begin to think in more complex ways. This growth enables them to understand and use the nuances and subtleties of language.  Most of them can tell the time in hours, but they may have trouble with concepts such as half past and quarter to, especially with the prevalence of digital clocks  They know the months of the year and can name the months in which holidays fall.  Much of a child’s talk is concerned with these concepts as he or she practices them and shows them off for family and friends  By age 9, they discover dirty jokes and share them to friends or try to understand those shared by adults  By 12 years, a sense of humor is apparent  Common Fears and Anxieties  Anxiety related to Beginning School: Adjusting to grade school is a big task for 6 years old. Even if they attended preschool,

grade school is different: the rules are firmer and the elective feeling is gone  School Phobia: Fear of attending school; children who resist attending school this way may develop physical signs of illness, such as vomiting, diarrhea, headache or abdominal pains on school days.  Home Schooling  education of children at home, typically by parents but sometimes by tutors, rather than in a formal setting of public or private school. Homeschooling is a legal option in many places for parents to provide their children with a learning environment as an alternative to publicly-provided schools. Parents cite numerous reasons as motivations to home school, including better academic test results, poor public school environment, improved character/morality development, and objections to what is taught locally in public school. It is also an alternative for families living in isolated rural locations or living temporarily abroad.  Latchkey Children  Schoolchildren who are without adult supervision for part of each weekday.  The term alludes to the fact that they generally carry a key so they can let themselves into their home after school  A major concern is that latchkey key children can feel lonely or have an

increased tendency to have accidents, delinquent behaviors, alcohol and beginning drug abuse, and decreased school performance from lack of adult supervision.  Sex Education  It is important that school aged children be educated about pubertal changes and responsible sexual practices so they are well prepared for these.  Preteens should also have adults whom they can turn to for answers to questions about sex  Ideally, these should be parents, but because sex is an emotionally charged topic, some parents may be extremely uncomfortable discussing it with their children. As a result, health care personnel often become resource persons.  When your school-age child inquires about sex, ask what he or she already knows. Correct any misconceptions, and then offer enough details to answer the specific questions. Don't laugh at your child's questions or use nicknames for your child's sexual anatomy, which may send the signal that these body parts shouldn't be discussed.  Stealing  Stealing occurs because although the child is gaining an appreciation for money, this

appreciation is not yet balanced by strong moral principles.  This usually happens at around 7 years of age, when children are first learning how to make change and discovering the importance of money. Stealing is one of the most common acts that children get involved in, especially during their school life. Some do it consciously. Most of them seize other people’s belonging unconsciously. At this age, children cannot differentiate between their things and those of others and hence, steal. The act of stealing, which has become a prevalent child behavior problem, is an immediate concern for parents. But before taking any corrective steps, they must try to find out the reason why their child is indulging in such a behavior. There are several facts that compel children to steal, such as low self-esteem, peer pressure, etc. It might also be possible that they do not have friends and are trying to ‘buy’ their friends.  Violence and Terrorism  Children basically view their world as safe, so it is a shock to them when violence such as at school shooting or international terrorists enter their lives  Children at this age tend to imitate and follow what they see on the TV. It is important to filter the shows the child watches so as to prevent them from following the violent actions.  Bullying

 A frequent reason that school-aged children cite for feeling so violent that they turn guns in fellow classmates is that they were ridiculed or bullied to the point they could no longer take such abuse

 Children with alcoholic parents are prone to abuse, may it be physical or emotional. They may also see this as something right and fun since their parents are doing so.  Obesity

 Some children bully others, either because they want to feel more superior, to get attention, or because it is the type of environment they live in. It’s best to talk to them about his and tell them that this should not be tolerated. Immediate action must be made.

 As many as 50 % of school age children are obese by body mass index guidelines for ideal weight. Some of these children have been overweight since pregnancy; their prepubertal weight gain makes them obese  Children who are obese tend to be laughed at or gain low self esteem from peers, and sometimes may cause isolation and discrimination. Nutritional teaching and guidance should be done by parents in order to aid the child, but do not scold the child nor make fun of him. Instead, tell him the good things that will happen to him/her if they eat right and engage in sports.

 Recreational Drug Abuse  Because alcohol and inhalants are available in so many homes and often can be purchased in small stores without proof of age, these are the commonly abused drugs of this age group.  Some become addicted to glue, thus this may cause physical effects in the future and this must be reprimanded immediately.  Children of Alcoholic Parents  As many as one in five children live with an alcoholic parent  Such children are at a greater risk for having emotional problems  Alcoholism may have a genetic cause, so children of alcoholics are more likely to become alcoholics

Source: Pilitterri, A., 2003. Maternal and Child Health Nursing: Care of the Childbearing and Childrearing family. Philippines: Lippicott Williams and Wilkins.