School Age

1. School Age 6-12 years a period of Industry and Cognitive Development

2. The School Age Child • Begins w/loss of 1st tooth & ends w/puberty • Average gains: • Weight: 5 lbs/yr. • Height: 1-2”/yr • Avg 6yr: 116cm (45”) – 21kg (46#) • 12yr: 150cm (59”) – 40kg (88#) • Slimmer, steadier, lower center of gravity • Linear growth: will outgrow shoes first, then pants & shirts • Males & females differ little in size

3. Prepubescence • Prepubescence – end of mid childhood; 2-year period that precedes puberty • Girls begin puberty & reach maturity ~ 1.5-2 yrs earlier than boys • Time of rapid growth; development of secondary sex char.; wt gain • Girls: breast development; pubic hair • Boys: penis and scrotum enlarge; ↑ muscle mass

4. Growth & Maturation • Sequence is progressive and predictable • Girls • Thelarche (breast development) 8-12.75 yrs (caucasian); 7-11 yrs (African American) • Pubarche (growth of pubic hair) ~2-6 mos later • Menarche ~ 2yrs after breast buds appear • Boy changes occur between 9.5 & 14 yrs • Initially pubic hair appears, then penile and testicular enlargement • Other: voice changes, facial hair, axillary hair • Gynecomastia common but temporary (~2yrs)

5. Physical Growth Girls: PHV (peak height velocity) ~ age 12 • 6-12 mos before menarche; grow ~ 2” after menarche • PWV ~ 6 months after PHV • Pubertal delay if no breast development by age 13 or no menarche within 2-2.5 yrs of breast development Boys: PHV ~ age14 • Boys ht & wt occur simultaneously; ceases ~ 18-20 yrs • Pubertal delay if no enlargement of testes or scrotal changes by ages 13.5-14 or genital growth not complete 4 yrs. after testicles begin to enlarge • Tanner stages used during physical exams (pp 742-743)

6. Psychosocial Development • Freud: latency period; tranquility time • Erikson: Sense of industry, stage of accomplishment; failure results in an inferiority complex • Peer approval motivating power • Reinforcements and recognition provide encouragement

7. Psychosocial Development • Sense of accomplishment involves ability to cooperate, compete, & cope w/others • Learn value of doing things w/others to accomplish goals • Temperament:easy; slow to warm up; difficult may need practice sessions & role play to prepare for events/transitions

8. Cognitive Development (This is BIG!) • Piaget – Concrete operations • use their thought processes to experience events and actions • Concrete-operational period (7-11 yrs): develop an understanding of relationships between things and ideas • Able to make judgments based on reason; “conceptual thinking” • Can use their memory stores to evaluate and interpret the present

9. Cognitive Development (cont) • Begin to see things from another’s point of view • Major cognitive tasks: conservation • Numbers 1st, then substance, vol last • Classification skills are BIG – love collections of anything • Learn to tell time and manipulate numbers (add, subtract, divide, multiply) • Biggest skill: Ability to READ

10. Moral Development (Kohlberg) • Moral Development • Development of conscience & moral standards • Age 6-7: reward & punishment still rules • Older: moves to judging an act by intentions that prompted it rather than just consequences • Begin to see other’s pt of view so are able to understand concept of treating others as they would like to be treated

11. Language Development • Language Development: complex • Improved grammar & word usage • Enjoy jokes, riddles, puns • Begin to understand metaphors & figurative statements • Begin to evaluate and clarify messages

12. Social Development • Identify with peers as gain independence from family • More sensitive to social norms and pressures of the peer group • Sex-role learning becomes more important with same sex peers • Having “best friends” a very big deal • Belonging to a group very imp.; group rules can be very rigid

13. Social Development • Parents still primary influence in shaping their personalities, setting standards for behavior and setting value systems • Still need and want parental control and feel secure knowing there is an authority to implement controls and restrictions • Need firm, secure parental interest and concern, not just a “pal”

14. Body Image • Acutely aware of their own bodies compared to others • Body integrity important • Concern re: threat or injury to it • Need reassurance about both the uniqueness and sameness of their body • If different, may be excluded from groups • When teased or criticized abt. being different, effect can be life long & lead to feeling inferior

15. Perceptions of Death • Most realize death is final, universal & inevitable by age 9-10 • Believe they may die but only in distant future; if faced w/death feel loss of control • Fear pain associated with death • May feel guilt and responsibility about someone’s death – need logical, factual explanations

16. Chronic Illness • If can’t develop sense of achievement as a result → feel inadequate • Involve in own care and decision making • If feel different – may try to hide it • Give factual info in simple terms • Help with school transitions • Need alternative activities • Camps for children w/similar challenges

17. Self Esteem • How they view their worth in both pos & neg qualities is based on feedback they receive • Adults can make them feel special & successful – shaping self concept • Emphasize strengths & positive aspects of behavior • Teachers, parents, coaches, etc – big influence • Positive self concept leads to feelings of self-respect, self-confidence, happiness

18. Sexuality • Many experience some sort of sex play out of curiosity prior to adolescence • Usually transitory; this should be taken as an opportunity to talk about sexuality; to provide info; use correct terminology; be concrete • Ideal time for sex ed presented as normal part of growth and development • Provide info on AIDS and dispel myths

19. Play • Belonging to a club or team is important • Rules can be extreme and made up • Conformity and ritual are part of the play • Team play to attain a goal • Learn about nature of competition • Learn rules, make judgments, plan strategies, learn interdependence • Complex board, card, & computer games • Collections

20. Discipline • Now able to understand the effects of their actions on others • Reasoning is an effective technique • Problem solving is best and children can be included in the process • Others: withholding privileges, requiring recompense, imposing penalties, contracting

21. Dishonest Behavior • Lying: all lie sometimes; often d/t role modeled behavior • Cheating: most common 5-6 yr; usually disappear as matures; role model imp. • Stealing: bet. 5-8 yrs sense of property rights is limited; may steal and lie about it or may steal to make up for love or something else they may be lacking

22. Stress • Other concerns: stress (more than previous generations); exposure to violence; school environment; pressures to excel; being over programed by parents; worries about home problems (more divorce), expected to be more mature, Latchkey Children (see p. 665) • Box 17-1; p. 663 excellent summary re: common stresses for different ages

23. Health Promotion • Ideal time to take responsibility for their health by end of middle childhood • Self-care in hygiene, nutrition, exercise, recreation, sleep, and safety • Health education can help them learn abt their bodies; how their beh affects their health; helps them make good decisions • Teach them to take active role in relationships with health care providers

24. Nutrition • Junk food more available – fill up on empty calories • School lunch – parents don’t know what child really eats even if send own lunch • School lunch and breakfast program help meet needs of kids but often are high in fat • Increase in obesity; increase in sedentary activities • Fast food – major contributor to obesity

25. Sleep and Rest • Amt. is individualized; ~ 9 ½ hrs • Need routine and firm bedtime; should not be used as punishment • Sleepwalking: 1st 3-4 hrs of sleep – no memory; not purposeful; leave alone unless in danger; self limiting • Sleep talking- non purposeful; no harm • Nightmares: less common; chronic-refer

26. Physical Activity • Fewer resources for PE, playgrounds and after school programs at schools • Only IL requires requires daily PE from K-12 • TV: kids have become less active; 26% 4hrs/day; 67% 2hr/day • Violent TV – increase in aggression, feel desensitized • Video games: critics violence, tension, sleeplessness, others improve eye-hand coord.

27. Dental Health • First permanent teeth by 6yrs • 3rd permanent molars (wisdom) 18-25 yrs • Up until 2nd grade dexterity to properly brush isn’t there so need supervision • Bedtime brushing esp. important • Flossing done by parents til ~ 8-9 • Malocclusion – may need orthodontic tx • Dental evulsion: replacement or reattachment

28. Evulsed Tooth • Hold by crown – do NOT touch root area • Rinse if dirty under running water or saline • Reinsert and hold in place – Transport • Replace within 10” if possible • If within 30”, 70% chance of success • If transport tooth, use saliva, milk, or saline (contact lens solution) – NOT WATER!

29. Injuries • Reflect their developmental stage p. 744 • Risk Taking: Peer pressure begins so risk-taking injuries increase • MVA: most common cause of accidental injury and death • Pedestrian deaths 2.5x more freq w/ peak incidence 5-9yrs • ATV’sresponsible for significant # injuries for children under 16

30. Injuries (cont) • Bike:500,000 ER visits, 900 deaths annually; deaths caused by head injuries • Skateboards, rollerblades, Ride-on mowers, trampolines, flipping, horseback riding, sledding • School: most injuries on the way to & fro • Guns: firearm deaths <15 yrs, ~12x greater than 25 other industrialized countries

31. That’s it! Aren’t School age kids some of the coolest?? !!