Learnings about growth and development

1. SCHOOL-AGE GROWTH
AND DEVELOPMENT

2. PHYSICAL GROWTH AND DEVELOPMENT
• GENERAL GROWTH PARAMETERS
- girls usually grow faster than boys and
commonly surpass them in height and
weight
- preadolescence, which extends from
about ages 10 to 14, a child
commonly experience rapid growth.
- immune system becomes more
efficient, allowing for more
localization of infections and better
antibody-antigen response.
- develop immunity to a wide number of
organism
- Many develop several infections in the
first few years of school because of
increased exposure to other children
with germs.
• Height
• The ave school-age grows 2 inches
per year
• The ave 6yo is 45 inches
(114.3cm)tall.
• The ave 12yo is 59 inches (149.9cm)
tall.
• Weight
• Ave school-age child gains 4 ½ to 6 ½
lb (2 to 3 kg) per year
• The ave 6yo weighs 46 lb (20.9kg)
• The ave 12yo weighs 88 lb (39.9kg)

3. Nutrition
1.Nutritional requirements
• daily caloric requirements diminish in relation to body
size.
• average of 2400 calories per day.
• Caregivers should continue to stress the need for a
balanced diet from the food pyramid: the body is
storing resources for the increased growth needs of
adolescence.

4. NUTRITION
2. Food Patterns and preferences
may still be a “picky” eater but should be more willing to try new
foods.
may trade, sell, or throw away home-packed school lunches.
At home the child should eat what the family eats; the patterns that
develop now stay with the child into adulthood. The child’s eating
patterns should reflect family culture.
Many still dislike vegetables, casseroles, liver, and spicy foods.
may go on “food jags.” (eating only one type of food at a time)
Family members play an important role in the child’s food
preferences; however, peers and the media are also influences.
Without adult supervision, school-age children typically make poor
food choices

5. Nutrition
3. Overweight and Obesity
More than 90% of obese children are
overweight due to overeating, with
underactivity playing a significant role

6. SLEEP PATTERNS
•May vary but typically range from 8 to 9 ½ hours
nightly
•Can be later than during the preschool period but
should be firmly established and adhered to on school
nights.
•Reading before bedtime may facilitate sleep and set up
a positive bedtime pattern
•Children may be unaware of fatigue if allowed to
remain awake, they will be tired the next day.

7. DENTAL HEALTH
• Permanent teeth erupt at 6 y.o., and gradually loses the deciduous
tooth
• Regular dental visits, fluoride supplements should continue when the
water supply is insufficiently fluoridated.
• Brushing of teeth after meals with a soft nylon toothbrush; because
of child’s improved coordination, parental supervision and assistance
usually are not necessary.
• Parents should floss the child’s teeth until the child reaches age 8 or
9.
• Carries, malocclusion, and periodontal disease become evident in
this age-group

9. ELIMINATION
• 85% of children have full bowel and bladder control by 6 y.o.
• Elimination patterns are similar to adult patterns.
• Bowel movement occur on average 1 to 2x/day
• Urination occurs 6-8x/day; average of 500-1000ml/day
• Common problems include the following:
• Nocturnal enuresis (bed-wetting) occurs in 15% of 6 y.o., 3% of 12y.o., and 1%
of 18 y.o.
• Encopresis (persistent stool leakage) occurs in 1.5% of second-grade children
• Boys have more frequent problems with soiling and constipation than do girls.
Such problems require referral to a primary health care providers.

10. II. MOTOR DEVELOPMENT
•Gross motor development
• Bicycling
• Roller skating, rollerblading, and skateboarding
• Progressively improved running and jumping
• swimming
•Fine motor development
• Printing in early years: script in later years (by age 8)
• Greater dexterity for crafts and video games
• Computer competence (manual skills

11. RELATED SAFETY
• accepts more responsibility for personal health care and injury
prevention
• Children’s developing cognitive skills complement their own judgments
and assist in helping them avoid many type of injuries.
• still prone to accidents, mainly owing to increasing motor abilities and
independence (bicycle can take a child farther from home
independently).
• Major sources of injuries: bicycles, skateboards, and team sports learning
proper techniques, using safe equipment and, in the case of organized sports,
good coaching and well-matched teams (similar size) can reduce the risk of
injury.
• School-age children who learn safe swimming and diving practices, fire safety,
use of seat belts and bicycle helmets, and other safety practices are at
reduced risk for injury.

12. RELATED SAFETY
•Parents should continue to provide guidance for new
situations and threats to safety.
•School-age children should receive education about the
use and abuse of alcohol, tobacco (including chew and
snuff), and other drugs.

13. FEARS AND STRESSORS
1.During the school-age years, many fears of earlier
childhood resolve or decrease; however school-age
children may hide fears to avoid being labeled
“chicken” or a “baby”
2.Common Fears
a.Failure at school
b.Bullies
c. Intimidating teachers
d.Something bad happening to parents

14. FEARS AND STRESSORS
3. Common Stressors
a. Stressors for young school-age children are teasing, decision-making,
need for approval, loneliness, independence, and the opposite sex.
b. Stressors for older school-age children are sexual maturation, shyness,
health, competition, peer pressure, and temptation to use drugs
4. Parents and other caregivers can help reduce a child’s fears by
communicating empathy and concern without being overprotective
5. Children need to know that people will listen to them and that
they will be understood.

15. SOCIALIZATION
1.The school-age years are a period of
dynamic change and maturation as the
child becomes increasingly involved in
more complex activities, decision-
making, and goal-directed activities.
2.As a school-age child learns more about
her body, social development centers
on body and its capabilities.
3.Peer relationships gain new importance
4.Group activities, including team sports
typically consume much time and
energy.

16. Play and Toys
1.Play becomes more competitive and complex during the school-age period.
2.Characteristics activities include team sports, secret clubs, “gang” activities,
scouting or other organizations, complex puzzles, collections, quiet board
games, reading, and hero worship.
3.Rules and rituals are important aspects of play and games.
4.Toys games, and activities that encourage growth and development include:
a. Increasingly complex board and card games
b. Books and crafts
c. Music and art
d. Athletic activities
e. Team activities
f. Video and computer games (Encourage parental monitoring of content to avoid
exposure to gratuitous violence and sexual situations)
g. Computer activities. (Encourage parental monitoring to avoid exposure to internet
predators

17. DISCIPLINE
1.School-age children begin to internalize their own controls and need
less outside direction. They do, however, need a parent or other
trusted adult to answer questions and to provide guidance and
decisions.
2.Regular household responsibilities help school-age children feel that
they are an important part of the family and increase their sense of
responsibility.
3.A weekly allowance, set in accordance with a school-age child’s needs
and duties, assists in teaching skills, values, and a sense of
responsibility.
4.When disciplining school-age children, parents and other caregivers
should set reasonable

18. SEXUAL DEVELOPMENT
• Preadolescence begins near the end of the school-age
years.
• discrepancies in growth and maturation between sexes
becomes apparent.
• acquire much knowledge of and many attitudes toward
sex at earlier stages. During the school-age years, they
refine this knowledge and these attitudes .
• Questions about sex require honest answers based on
the child’s level of understanding.

19. LANGUAGE
1.The child develops formal adult articulation patterns
by age 9.
2.The child learns that words can be arranged in terms of
structure.
3.The ability to read is one of the most significant skills
that the child develops.

20. Safety Measures for LATCHKEY CHILDREN
• Post a list of emergency telephone numbers and make sure that the child
knows how to use them.
• Instruct the child to tell callers that parents cannot come to the telephone
because they are busy instead of saying that parents are not home.
• Teach the child first aid and basic safety (e.g. fire, weather-related safety, and
cooking) as appropriate.
• Establish an after school routine, and make sure that the child understands it.
• Instruct the child to lock the doors and to not display the key to others.
• Consider getting a pet to provide company for the child.
• Arrive home when planned. If a delay is necessary, telephone the child to
alleviate anxiety.

21. WELLNESS PROMOTION
A.General – encourage the family to follow guidelines for well child care
visits, screening, immunizations, and safety.
B.Nutrition
1. Encourage healthy eating patterns and help shape the child’s food preferences
positively.
2. Remind children and their caregivers to limit junkfood
3. Teach the basics of the food pyramid and help the child differentiate nutritious
foods from junk foods
C.Sleep – encourage the family to agree on a bedtime and allow
flexibility on non-school nights
D.Growth and Development
1. Foster a sense of industry by encouraging the child’s skill development in
school, sports, play, and other activities.
2. Counsel families about safety measures for latchkey children if needed
3. Encourage parents to limit the family’s TV watching

22. WELLNESS PROMOTION
E.Family
1. Encourage open communication
2. Foster responsibility with chores and adherence to family rules and schedules
3. Encourage decision-making and individuality as the child learns to accept the
consequences of his own actions
4. Encourage parents to get to know the child’s peer group. Peers are important,
but the child will turn to family for support and approval.
F.Health
1. Promote self-care and hygiene, including flossing
2. Monitor the child for behavior problems
G.Anticipatory Guidance – teach the child about puberty and all its
physical and emotional changes; drugs, alcohol, and tobacco; and sex
education.

23. VIII. Illness and Hospitalization
A.
1. Stressors include immobilization, fear of mutilation and death, and
concerns over modesty.
2. School-age children have difficulty with forced dependency. They
may be unable to express themselves verbally and their self-
consciousness may interfere with care.
B.Reactions to Illness
1. School-age children perceive external forces as causes of illness
2. They are aware of the significance of different illness. For example,
they know that cancer is more serious than a “cold.”

24. VIII. Illness and Hospitalization
C.Reactions to Hospitalization
1. The primary defense mechanism of school-age children is reaction
formation, an unconscious defense mechanism in which the child
assumes an attitude that is opposite of the impulse they harbor.
Typically, the child states he is brave when he is really frightened.
2. School-age children may react to separation by demonstrating
loneliness, boredom, isolation, and depression. They may also
show aggression, irritability, and inability to relate to siblings and
peers.
3. The sensed loss of control is related to enforced dependency and
altered family roles.
4. Fear of bodily injury and pain results from fear of illness, disability
and death.

25. VIII. Illness and Hospitalization
•Nursing Management
1.Provide General Interventions
a.Encourage verbalization
b.Encourage self-care
c. Encourage peer interactions
d.Inform school-age children that it is “OK” to cry.
e.Give factual information; use models to demonstrate
concepts or procedures.
f. Provide diversions

26. VIII. Illness and Hospitalization
•Nursing Management
2.Provide physical comfort and safety interventions
a.Allow the school-age child control over bodily functions
b.Assist in developing fine motor skills. Encourage:
• Construction toys, such as lego sets
• Drawing
• Computer games
• Drawing body parts
• “taking notes” during patient education
c. Allow school-age children to participate in treatment

27. VIII. Illness and Hospitalization
•Nursing Management
3.Provide cognitive interventions
a. Assist in developing rational thinking (give scientific explanation,
rationales, and rules) and provide for decision making.
b. Assist the child with mastering concepts of conservation,
constancy, and reversibility, classification, and categorization
• Allow the child to chart intake and output and vital signs
• Encourage the child to tell the nurse when procedure are due.
• Help the child create a scrapbook
• Use concepts, such as cards and board games, in teaching and games
• Encourage the child to do schoolwork.
c. Provide time for, and encourage verbalization (talk time)

28. VIII. Illness and Hospitalization
•Nursing Management
4.Provide psychosocial and emotional interventions.
a.Provide the opportunity to channel drives.
• Encourage peer interaction, group education, and limit
setting
• Avoid coed rooms
b.Promote achievement of industry
• Praise cooperative play
• Assign tasks that the child can accomplish
• Involve the child in care

29. Thank you!!!