School-age children development ages 6 to 12 years old.

1. School-age children developmentages 6 to 12 years old.

2. Maturation of systems • Healthiest years of childhood. • Gastrointestinal is reflected in fewer stomach upsets, better maintenance of blood sugar levels and an increases stomach capacity. • Caloric needs are less than they were in the preschool years and less than they will be during the coming adolescent growth spurt. • Bladder capacity generally greater in girls than in boys, there are individual variations in frequency of urination and differences in the same child according to circumstances such as temperature, humidity, time of day, amount of fluids ingested, and emotional state.

3. The immune system become more competent in its ability to localize infections and to produce an antibody-antigen response (levels of IgG & IgA antibodies increase & reach adult’s level). • The heart grows more slowly during the middle years and is smaller in relation to the rest of the body than at any other period of life (Innocent heart murmurs may be heard due to the changing size of the heart in reference to the thorax).

4. Physiologic splitting of heart sounds may be present for the first time (pulmonary valve tend to close slightly later than the aortic valve (lub d-dub), usually associated with inspiration). • At 6 year-old frontal sinuses are developed increases the possibility of sinus headache. • Brain growth is complete by age of 10 years; as a result fine motor coordination becomes refined.

5. Preadolescence • The period that begins toward the end of middle childhood and ends with the thirteenth birthday. • There is no universal age at which children assume the characteristics of preadolescence. • The first physiologic signs begin to appear of about 9 years (particularly in girls) and are usually clearly evident in 11-12 years-old children. • Either early or late appearance of these characteristics is a source of embarrassment to both sexes.

6. Physical Development • School-age children typically exhibit fairly smooth and strong motor skills. However, they vary widely in coordination (especially eye-hand), balance, and physical tolerance. • Gender differences in gross motor skills become increasingly pronounced with boys outperforming girls (ride a bike, swim, ice skate, skip a rope)

7. Fine motor skills may also vary widely and influence a child's ability to write neatly, dress appropriately, and perform certain tasks, such as making beds or doing dishes. • Other fine motor skills such as typing at computer keyboard, drawing detailed pictures.

8. There will be significant differences in height, weight, and build among children of this age range. It is important to remember that genetic background, as well as nutrition and exercise, may influence growth. • A great deal of variance also occurs with the age at which children begin to develop secondary sexual characteristics

9. Weight increased by 2 – 3 kg/year. • Height: 2.5-5 cm/year. • Average 6 year-old Wt. is 21 kg. • Average 6 year-old Ht. is 116 cm. • Average 12 year-old Wt. is 40 kg. • Average 12 year-old Ht. is 150 cm. • Pulse rate decrease to 70-80bpm. • Blood pressure increased to 112/60 mm Hg. • Respiration is 20-25 breath/ min.

10. Teeth • Age of loose tooth: deciduous teeth are gradually lost and permanent teeth erupt around age of 6 years. • Average child gains 28 teeth between 6 and 12 years. • Regular dental visits. • Regular brushing. • Malocclusion and dental caries are common.

11. Sleep • Younger school age: 10-12 hr/d • Older school age: 8-10 hr/d • Nighttimes terrors may continue

12. Play • As children enter the school years, their play takes on new dimensions that reflect a new stage of development. Not only does play involves increased physical skill, intellectual ability, and fantasy, but also as children form groups, they begin to evolve a sense of belonging to a team or club. • The games they play have fixed and unvarying rules that may be bizarre and extraordinarily rigid.

13. Sticker Riot Rules • Keep club a secret. • Must come to as many meetings as possible. • Must bring sticker to every meeting • When in another house for meetings do not come in house unless told. • When at house don’t touch or eat anything unless told. • If you don’t come to a meeting you must make up the meeting at someone’s house. • If you miss a meeting you can bet that the other members are still going to have the meeting.

14. They also enjoy many quit and solitary activities such as collections. • The newly acquired skill of reading becomes increasingly satisfying. • Enjoy challenging play – video/computer games. • Around 7 years of age, imagination is declined. • Helping in kitchen with jobs (making salad).

15. Fears • Most of the new fears that trouble them are related to school and family (e.g., fear of failing, fear of teachers, bullies and bullying, and fear of something bad happening to their parents). • Excessive worry about past behavior. • Fear of kidnapping, death.

16. Language Development • Early school-age children should be able to consistently use simple, but structurally complete, sentences that average 5 to 7 words. As the child progresses through the elementary years, grammar and pronunciation becomes normal. Children use more complex sentences as they grow. • Language delays may be due to hearing problems or intelligence deficits. In addition, children who are unable to express themselves adequately may be more prone to exhibiting aggressive behavior or temper tantrums.

17. Psychosocial Development (Erikson) • Industry vs inferiority: the stage of accomplishment (how to do things well) • School-age children are willing to build skills and participate in meaningful and socially useful work. • Interests expand, and with a growing sense of independence, children want to engage in tasks that can be carried through to completion. • Failure to develop a sense of accomplishment may result in a sense of inferiority

18. Many aspect of industry contribute to the child’s sense of competence and mastery: • Intrinsic motivation associated with increased competence in mastering new skills and assuming new responsibilities • Extrinsic sources of reinforcement in the form of grades, material rewards, additional privileges, and recognition provide encouragement and stimulation

19. Characteristics of Concrete Operational Thought (Piaget) • Ages 7 – 11 years. • Conservation has developed. • Classification and categorization have developed. • Ability to resolve contradictions. • Comprehension of past, present, and future. • Understanding of reversibility; child has control and flexibility. • Using the alphabet for organization. • Ability to verbalize directions. • Ability to transpose (i.e., see things from another’s viewpoint). • Comprehension of relational terms. • Can use simple logic. • humor

20. Behavior • Frequent physical complaints (such as sore throats, tummy aches, arm/leg pain) may simply be due to a child's enhanced body awareness. • Although frequently no physical evidence for such complaints can be found, the complaints need to be investigated, both to rule out substantial conditions and to assure the child that the parent is concerned about his or her well-being (maintaining trust).

21. Peer acceptance becomes increasingly important during the school-age years. Behaviors that are important to be part of the group need to be negotiated with parents to allow the child to have some conformity and group standing without crossing beyond the boundaries of acceptable behavior within the family's standards.

22. Friendships at this age tend to be primarily with members of the same sex. In fact, early school-age children typically talk about how "strange" or "awful" members of the opposite sex are. This lack of appreciation of the opposite sex steadily diminishes as the child approaches adolescence.

23. Lying, cheating, or stealing are all examples of behaviors that school-age children may "try on" in learning how to negotiate the many expectations and rules placed upon them by family, friends, the school, and society in general.

24. Nutrition • Good appetites • Educate about healthy foods and balanced diet • Fostering industry by planning meals • Require more iron, fluoride & calcium: teething , pre-puberty • Obesity may occur (junk foods)

25. Promoting school safety: • More accidents as a result of being independent • Can follow instructions • Bicycle safety : use helmet • Drugs, tobacco use

26. Common Health Problems • Enuresis. • Dental caries. • Attention Defect Disorder (ADD)/Attention Defect Hyperactivity Disorder (ADHD). • Malocclusion:

27. Malocclusion • good jaw alignment is necessary for optimum teeth formation, health of supporting tissues, optimum speech development & pleasant appearance. • May be congenital and related to conditions such as cleft palate, small lower jaw or familial. • May result from constant mouth breathing

29. Treatment Braces are needed