School Age: Growth and Development

School Age Introduction

• School age children are between ages 6 and 12
• The school age period starts when the child enters school and sheds their first deciduous tooth
• This period finishes at puberty when they have acquired their final permanent teeth, excluding the wisdom teeth
• At this age, children begin to value friendships and participate in activities like sports or painting

Classification of School Aged Children

• Early school-age: 6-8 years
• Middle school-age: 8-10 years
• Late school-age: 10-12 years

Physical Growth in school years

• Growth occurs at a slower but steady pace, giving children more grace and steadiness
• Children become slimmer with longer legs
• Skeletal lengthening occurs along with fat diminution
• Muscle tissue increases
• Strength and physical capabilities double by the end of this period

Physical Growth Metrics

• Weight increases by 2-3 kgm per year
• Height increases by 5 cm per year, resulting in a gain of 30-60 cm
• At 6 years old, average height is 116 cm and weight is 21 kg
• At 12 years old, average height is 150 cm and weight is approximately 40 kg
• At 6 years, height and weight gain slowly with a 5 cm height increase and 2-3 kg weight increase per year
• Growth continues at 7-9 years at 5 cm and 3 kg a year
• At 10-12 years, height growth slows compared to rapid weight gain, with height increasing 5.25 cm and weight increasing 4.5 kg

Prepubescence

• It begins towards the end of middle childhood and ends by the thirteenth birthday
• It's the 2-year period preceding puberty

Systems Maturation

• Bladder capacity increases
• Immune system efficiency increases
• Bone ossification increases

Vital Signs

• Pulse: 80-90 beats per minute
• Respiratory rate: 20-21 breaths per minute
• Blood pressure: 100/60 mmHg

Teething

• Children have 28 permanent teeth, plus 4 wisdom teeth

Time of Shedding of Teeth

• Central incisors: shed at 7.6 years (upper) and 6 years (lower)
• Lateral incisors: shed at 8 years (upper) and 7 years (lower)
• Cuspid: shed at 11.6 years (upper) and 9.6 years (lower)
• First molar: shed at 10.6 years (upper) and 10 years (lower)
• Second molar: shed at 10.6 years (upper) and 11 years (lower)

Motor Development

• There is an increase in motor development, marked by increased time in play and activities
• 6-8 year olds can ride a bicycle, print words, run, jump, hop, and brush/comb their hair
• 8-10 year olds can participate in organized sports, require reminders to brush their teeth, and can dress themselves completely
• 10-12 year olds enjoy all physical activities and can cook or sew in small ways

Language Development

• Sentence structure continues to develop at a rapid pace to become more complex
• Speaking multiple languages is common
• Reading ability improves language skills
• Formal adult articulation patterns develop by age 7 to 9 years
• 6-year-olds use 2100 words, identify colors, know days of the week, use prepositions and complete sentences, and share experiences through language
• 7, 8, and 9-year-olds increase their word use to express themselves, exchange information, communicate, and consider others' perspectives
• 10, 11, and 12-year-olds use 50000 words, employ compound and complex sentences, and understand abstract concepts

Major Social Changes

• Children become more independent
• Gangs and groups are formed
• Discussions about life, death, sex, attitudes, values, beliefs, and games such as football and basketball
• The importance of the child and school are discussed
• Relations with family
• Relations with friends

Psychosocial Development (Erikson's Theory)

• Children acquire a sense of industry and overcome feelings of inferiority
• Children want to undertake tasks that they can complete successfully
• A child's energy goes into production and learns to be competent through doing
• The goal is to achieve personal and interpersonal competence by acquiring technical and social skills
• Skills are built and children participate in meaningful and socially useful work

How Mastering Skills Helps

• Mastering skills gives intrinsic motivation, social relationships and cooperation

Overcoming Inferiority

• Overcoming feelings of inadequacy due to disappointment in skills and perceived lack of abilities is key to a healthy psychosocial development

Psychosexual Development (Freud's Theory)

• The latency period is a period of tranquility between the Oedipal phase of early childhood and the beginning of sexual attraction in adolescence
• Relationships with same-sex peers are experienced during this time

Cognitive Development (Piaget Theory)

• During the pre-operational period (2-7 years), a child develops an emerging ability to think mentally
• During the concrete-operational period (7-11 years), children learn to reason about what they see and do in the present

Cognitive Development

• Concrete operations allow children to use their ways of thinking to experience events and actions
• The term operation is an action performed on an object or set of objects
• Classification skills involve the grouping of objects
• Mastering the concept of conservation, that physical objects do not appear and disappear by magic, is a key cognitive task

Moral Development (Kohlberg)

• Conscience and moral standards are developed
• They follow rules and judgments

Spiritual Development

• Prayer and religious rituals often comfort children
• Religious activities help children cope with threatening situations
• Concrete thinking along with a desire to learn about a higher power is common
• The higher power is often pictured as human with loving and helping actions
• Religion may be learned through daily prayer

Play

• Cooperative play is important
• Children in this age group like to play in groups and share games
• Board games, computers, and reading stories are liked
• It is important to limit TV watching and supervise the child to choose is the best choice

Needs of School Age Children

• Needs include:
  • Rules and rituals
  • Guidance and supervision
  • Preparation for school
  • Defined parental and teacher roles
  • Social relationships and cooperation with family
  • Clubs and peer groups
  • Development of self-concept, body image, self evaluation and self-esteem

Sex Education

• Children should be educated about sex
• They should be informed about the reproductive cycle and their role approaching puberty
• Both female and male changes should be discussed by parents
• Girls should be told about the menses by the age of 10 years

Other Needs

• Team play (cooperative play)
• Quiet games and activity, and sports
• Ego mastery
• School experience, sleep, and rest

Problems of School Age Children

• Common problems include:
• Discipline issues
• Dishonest behavior
• Coping with stress
• Fears
• Being a latchkey child
• Accidents and injury
• Nutrition issues
• Outside influences on behavior
• Sleep problems and night terrors
• Difficulty mastering ego and adjusting to school
• The child may get anxious because of school concerns
• Anxiety problems may be caused by school phobia (fear), or trouble keeping up in school
• The child may avoid going to bed, or have trouble falling or staying asleep
• Sleep problems may be caused by breathing problems, too much anxiety, or poor sleep scheduling

Learning Difficulties

• Problems affecting brain development may lead to a decreased ability to think, learn, and remember
• Feelings of loneliness and rejection may also decrease a child's desire to learn

Social problems

• Poor behavior may cause problems with social skills, such as smoking and drug abuse

Poor Nutrition

• A lack of physical activity contributes to poor nutrition
• They prefer fast food or junk food and lack physical activity, which can result to being underweight, overweight, or at risk of growing overweight
• These conditions may lead to medical problems, such as diabetes, obesity, hypertension, and hyperlipidemia

Red Flags

• School failure
• Lack of friends
• Social isolation
• Aggressive behavior (fights, fire setting)

Care Of School-age Child

• Nutrition: 3 meals or snacks per day including all food groups, a breakfast is also important
• Encourage eating well balanced diets while also avoiding fast foods
• Meal times should never be used for nagging, finding fault, or correcting manners
• Teach children the benefits of hand-washing before eating
• Encourage physical activity & dietary fat should be limited to discourage obesity
• Encourage good dental hygiene and prevention of dental caries
• Getting 10 - 12 hrs of sleep per day
• Take care around motor vehicle accidents
• Always have supervision around drowning
• Prevention of smoking, drugs, and peer pressure.
• Adjustment to school.
• Discipline.
• Immunization.

Role of Parents

• Encourage children to do physical activity according to their liking
• Be sure your child wears the proper protective equipment during practicing sports
• Notice how they are responding to changes in themselves and their friends
• Take interest in what they are doing and where they are going
• Check whether they are coping in school and assist if necessary