Chapter_034.pdf

Perry: Maternal Child Nursing Care, 7th Edition Chapter 34: The School-Age Child and Family Key Points Middle childhood, also known as the school years, is the period of life that extends from 6 to 12 years of age. Although growth is slower than in previous years, there is a steady gain in height an...

Perry: Maternal Child Nursing Care, 7th Edition Chapter 34: The School-Age Child and Family Key Points Middle childhood, also known as the school years, is the period of life that extends from 6 to 12 years of age. Although growth is slower than in previous years, there is a steady gain in height and weight, with maturation of body systems. A sense of industry (Erikson), or sense of accomplishment, occurs somewhere between 6 years old and adolescence. School-age children are eager to develop skills and participate in meaningful work. Piaget’s period of concrete operations refers to the school-age period when children are able to use their thought processes to experience events and actions and make judgments based on reasoning. School-age children picture God as human and use adjectives such as “loving” and “helping” to describe their deity. They are fascinated by the concepts of hell and heaven, with a developing conscience and concern about rules. They may fear going to hell for misbehavior. Entertaining different points of view, becoming sensitive to social norms, and forming peer friendships are important features of social development during the school years. Team play, quiet games and activities, and acquisition of skills are prime elements of play during the school years. Rules and rituals, and ego mastery, assume greater importance. The term self-concept refers to a conscious awareness of self-perceptions, such as one’s physical characteristics, abilities, values, self-ideals and expectancy, and idea of self in relation to others. It also includes one’s body image, sexuality, and self-esteem. Body image is what children think about their bodies and is influenced by significant others. Children are acutely aware of their own bodies, and also deviations from the norm. The term latchkey children is used to describe children who are left to care for themselves before or after school without the supervision of an adult. Parental concerns during middle childhood include involvement in dishonest behaviors like lying, cheating, and stealing. The pressures of balancing school activities and achievement are also concerning to parents. Children today experience significant amounts of stress, which can cause Copyright © 2023, Elsevier, Inc. All Rights Reserved. long-term adjustment and health problems. Stress in childhood comes from a variety of sources such as conflict within the family, parental criminality or psychiatric disorder, low socioeconomic status, the school environment and participation in multiple organized activities. The nurse who observes the following signs of stress in a child should explore the situation further: stomach pains or headache, sleep problems, bedwetting, changes in eating habits, aggressive or stubborn behavior, withdrawal or reluctance to participate, regression to earlier behaviors (e.g., thumb sucking), trouble concentrating, or changes in academic performance. The easy availability of high-calorie foods and the influence of mass media, combined with the tendency toward more sedentary activities, has led to the epidemic of childhood obesity. Dental care is important during this time; potential dental problems include caries, periodontal disease, and malocclusion. Regular dental supervision and continued fluoride supplementation are critical to the health maintenance program. When presenting sexual information to school-age children, nurses should treat sex as a normal part of growth and development. Routine health services provided by most schools include health appraisal, emergency care, safety education, communicable disease control, counseling, and follow-up care. Injury prevention is directed toward safety education, provision of safe play areas and equipment, and well-supervised sports activities. A major clinical manifestation of ADHD observed in school is distractibility. Children with PTSD should be encouraged to play out the stress and to discuss their feelings about the event. Manifestations of childhood depression include a sad face, tearfulness, irritability, solitary play or work, tiredness, lowered grades, and withdrawal from previously enjoyed activities and relationships. Childhood schizophrenia is characterized by symptoms that last for at least 6 months and seriously interfere with the child’s functioning in school, at home, or in other social situations. Copyright © 2023, Elsevier, Inc. All Rights Reserved.