Growth and Development of the School-Aged Child: 6 to 10 Years Chapter 26

1. Growth and Development of the School-Aged Child: 6 to 10 YearsChapter 26

2. OBJECTIVES • State the major developmental task of the school-aged group according to Erikson. • Discuss the physical growth patterns during the school-aged years. • Describe dentition in school-aged children. • Discuss the psychosocial development of the school-aged child. • Explain the cognitive development seen in the school-aged children regarding (a) conservation, (b) decentration, (c) reversibility, and (d) classification. • Identify nutritional influences on the school-aged child, including (a) family attitudes, (b) mealtime atmosphere, (c) snacks, and (d) school’s role. • List three factors that contribute to obesity in the school-aged child. • State two appropriate ways to help an obese child control weight. • Discuss recommended health promotion and maintenance for the school-aged child, including: (a) scoliosis screening, (b) vision and hearing screening, (c) dental hygiene, (d) exercise, and (e) sleep. • Discuss the need for sex education in the school-aged group and describe the role of the family, school, and others in this education. • Describe principles that a family caregiver can use to teach children about substance abuse. • Identify common inhalant products that children may use as deliriants. • Describe safety education appropriate for the school-aged group. • Discuss the effects of the progression in the 6- to 10-year-old child’s concept of biology, including the concepts of (a) birth, (b) death, (c) human body, (d) health, and (e) illness. • Identify factors that may influence the school-aged child in the health care facility.

3. Growth and Development of the School-Age Child • Areas of dramatic change between 6 and 10 years • First day of school • Thinking process • Social skills • Activities • Attitudes • Use of language • Industry vs. inferiority -if unsuccessful in completing activities during this stage, children develop a feeling of inferiority -success with completing the activities in this stage provides the child with self-confidence

4. Growth and Development of the School-Age Child (cont.) • Health becomes community concern • Starting school • Physical exam • Immunizations • Usually healthy time of child’s life • Accidents still pose serious hazard

5. Physical Development • Weight and height • Growth is slow and steady • Gains about 5 lbs. annually • Annual height increase about 2.5” (6 cm) • Period ends in the preadolescent growth spurt • Changes in dentition • Starts to lose deciduous (baby) teeth at about 6 years • Eruption of permanent teeth, 6 year molars (directly behind the deciduous molars) • These are important: key or pivot teeth-help shape the jaw and affect the alignment of the permanent teeth

6. ERUPTION OF PERMANENT TEETH

7. Physical Development (cont.) • Changes in skeletal growth • Spine is straighter • Abdomen is flatter • Body is generally more slender and long-legged • Bone growth in long bones • Cartilage is being replaced by bone at the epiphyses (growth centers at the end of long bones and at wrists) • Skeletal maturation is more rapid in girls than in boys

8. SKELETAL GROWTH 10 YEAR OLD 6 YEAR OLD

9. Question Tell whether the following statement is true or false. Erikson’s developmental task for this age group is industry versus inferiority.

10. Answer True Rationale: Erikson’s developmental task for this age group is industry versus inferiority. Q#1

11. Psychosocial Development • Displays a sense of duty and accomplishment • Engages in meaningful projects and sees them through to completion • Applies the energies earlier put into play to accomplishing tasks • Refines motor, cognitive, and social skills • Develops a positive sense of self

12. Psychosocial Development (cont.) • Not all children are ready for this stage due to environmental deprivation, a dysfunctional family, insecure attachment to parents, and immaturity • Unrealistic or excessive goals can cause problems later in life • When environmental support is adequate child should complete several personality development tasks at this age: • Developing coping mechanisms • Developing a sense of right and wrong • Accomplishing a feeling of self-esteem • Displaying ability to care for oneself

13. Psychosocial Development (cont.) • School age thought processes • 7 years – Piaget’sconcrete operational stage begins • Skills of conservation (the ability to recognize that a change in shape does not necessarily mean a change in mass or amount) significant • Conservation of numbers, number of cookies does not change when rearranged • Conservation of mass, amount of cookie dough is the same whether in ball form or flattened • Conservation of weight, a pound is a pound whether plastic or brick • Conservation of volume, half a glass of water is the same regardless of shape of the container (11-12 yrs.)

14. Psychosocial Development (cont.) • Each child is product of • Personal heredity • Environment • Cognitive ability • Physical health • Every child needs love and acceptance • Understanding, support and concern when mistakes are made • Thrive on praise and recognition

15. Psychosocial Development (cont.) • Factors affecting self-confidence • Consistent rules • Positive attention • Clear expectations

16. Psychosocial Development (cont.) • Development from ages 6 to 7 • Still employs magical thinking • Can sit still for short periods of time • Understands taking turns • Enjoys group activities • Begins to enjoy participating in real-life activities

17. Psychosocial Development (cont.) • Development from ages 7 to 10 • Questions parental standards as the ultimate authority • Becomes more impressed by the behavior of peers • Is increasingly interested in group activities • Moves from preoperational, egocentric thinking to concrete, operational, decentered thought

18. Psychosocial Development (cont.) • Development from ages 7 to 10 • Concepts displayed by the 7- to 10-year-old child • Decentration • Being able to see several aspects of a problem at the same time and to understand the relation of various parts to the whole situation • Cause-and-effect relations become clear • Magical thinking begins to disappear

19. Psychosocial Development (cont.) • Concepts displayed by the 7- to 10-year-old child (cont.) • Reversibility • Conservation of continuous quantity • The ability to think in either direction • Classification • The ability to group objects into a hierarchical arrangement • Collections

20. Question A school-age child aged 7-10 years moves from preoperational, egocentric thinking to what? a. Concrete, operational, centered thought b. Concrete, operational, decentered thought c. Cognitive, operational, centered thought d. Cognitive, operational, decentered thought

21. Answer b. Concrete, operational, decentered thought Rationale: Important changes occur in a child’s thinking processes at about age 7 when there is movement from preoperational, egocentric thinking to concrete, operational, decentered thought. Q#2

22. Nutrition • As coordination improves, the child becomes increasingly active • Requires more food to supply necessary energy • The nutritional needs of the school-age child should be met by choosing foods from all the food groups • Increased appetite and a tendency to go on food “jags” are typical • Offer choices • Supervise snacking habits • Matter-of-fact attitude about food by caregivers • Provide a positive mealtime atmosphere

23. Nutrition (cont.) • Obesity can be a concern • Causes • Genetic, environmental, or sedentary lifestyle factors • Interventions • Appropriate physical activity (moderately active for 60 minutes every day, or most days) • Limiting fat intake (no more than 35% of total calories) • Positive caregiver support -avoid nagging -avoid “clean your plate” rule -limit fast food meals

24. Nutrition (cont.) • Health teaching at school • Reinforce proper diet • Subsidized breakfast and lunch programs • Provide well-balanced meals (often children only eat part) • Old enough to be partially responsible for packing own lunch • Post school lunch menus Q#3

25. Health Promotion and Maintenance • Routine checkups • Annual physicals • Booster of tetanus–diphtheria vaccine every 10 years throughout life (Appendix J) • Visit to the dentist at least twice a year • 10-11 years: first exam for scoliosis • Vision and hearing screening-before entrance to school and on a periodic basis (annual, biannual)-often conducted by the school nurse

26. Health Promotion and Maintenance (cont.) • Family teaching • Proper dental hygiene-particularly 6 yr. molars • Exercise and sufficient rest (6 yr. old-12 hrs./night & quiet time after school to recharge; 7-10 yr. old/) • Health education • Caregivers should teach child about • Basic hygiene • Sexual functioning • Substance abuse • Accident prevention • School should include same topics in curriculum

27. Health Promotion and Maintenance (cont.) • Health education (cont.) • Sex education-time and place for formal education remains controversial • Includes • Helping children develop positive attitudes about their own bodies • Their own sex • Their own sexual role to achieve optimum satisfaction in being a boy or a girl

28. Health Promotion and Maintenance (cont.) • Sex education (cont.) • At various places in curriculum-often limited to 1 class, usually 5th grade • Covers different topics in different school systems-watch films about menstruation and developing bodies; separate classes for boys and girls • Caregivers may want to use printed materials • Teach about HIV

29. Health Promotion and Maintenance (cont.) • Health education (cont.) • Substance abuse education • “Just say no” programs • Teach unhealthy aspects of tobacco, alcohol and drug use • Children may experiment with inhalants • May contain deliriants • Can cause death

30. HEALTH PROMOTION AND MAINTANENCE CONT’D Common Products Inhaled as Deliriants-Box 26-1 • Model glue Varnish • Rubber cement Shellac • Cleaning fluids Hair Spray • Kerosene vapors Nail polish remover • Gasoline vapors Liquid typing correction fluid • Butane lighter fluid Propellant (whipped cream) • Paint sprays Aerosol paint cans • Paint thinner Solvents

31. Health Promotion and Maintenance (cont.) • Substance abuse education • Family caregivers should • Teach family’s values • Teach difference between right and wrong • Set and enforce rules of acceptable behavior • Learn facts about drugs and alcohol • Actively listen to the children in the family Q#4

32. Health Promotion and Maintenance (cont.) • Accident prevention-remains leading cause of death • Children must learn safety rules and practice them until they are routine • Children should know • Their full name • Caregivers’ names • Home address • Telephone number • How to call 911

33. Health Promotion and Maintenance (cont.) Safety topics for school-age group-page 598 • Traffic signals and safe pedestrian practices • Safety belt use for car passengers • Bicycle safety • Skateboard and skating safety • Swimming safety • Danger of projectile toys • Danger of all terrain vehicles • Use of life jacket when boating

34. Question Health promotion and maintenance is important in this age group. What is one topic that is important for the caregiver to teach the child? a. Positive body image b. How to use the stove c. How to call the health care provider d. Basic hygiene

35. Answer d. Basic hygiene Rationale: Caregivers have a responsibility to teach the child about basic hygiene, sexual functioning, substance abuse, and accident prevention.

36. The School-Age Child in the Health Care Facility • More accepting of experience than younger children • These children have changing concepts of • Birth • Death • The human body • Health and illness

37. The School-Age Child inthe Health Care Facility

38. The School-Age Child in the Health Care Facility

39. The School-Age Child in the Health Care Facility

40. The School-Age Child in the Health Care Facility

41. The School-Age Child in the Health Care Facility

42. The School-Age Child in the Health Care Facility (cont.) • Anxious about looking different than others their age • May be uncomfortable with nurse of the opposite sex • Inform families and children of rules as part of admission process

43. Nursing Care for the School-Age Child in a Health Care Facility • Explain all procedures to children and their families • Show equipment and material to be used • Outline realistic expectations of procedures and treatments • Answer children’s questions truthfully • Give children an opportunity to verbalize anxieties • Respect desire for privacy