School Age
 Deciduous teeth are ruptured and
 Assessment:
 Physical Growth and Development
 They grow slowly but steadily
 Annual average weight gain is
approximately 3 to 5 lb; the increase in
height is 1 to 2 inches
 Posture becomes more erect
 By age 10, brain growth is complete so fine
motor coordination becomes refined
 The eye globe reaches its final shape so
that an adult vision is achieved
 If the eruption of permanent teeth and
growth of the jaw do not correlate with the
final head growth, malocclusion with teeth
misalignment may result
 IgG and IgA reach adult levels and
lymphatic tissue continues to grow up until
about age 9
 Left ventricle of the heart enlarges to be
strong enough to pump blood to the
growing body
 Time of the onset for PUBERTY
 Changes in physical appearance lead to
problems and worries for both children and
their parents
permanent teeth erupt
 At age 6, children start to endlessly jump,
tumble, skip and hop (Gross Motor Dev’t)
 They have enough coordination to walk a
straight line
 At age 6 also, they can easily tie their
shoelaces (Fine Motor Dev’t)
 Cognitive
 Period from 5-7 years is a transitional
stage when children undergo a shift from
the preoperational thought they used as
preschoolers to concrete operational
thought or the ability to reason through
any problem that they can actually
visualize
 Several new concepts learned by school-
age children includes:
• Decentering- ability to project self
into other people’s situation
• Accommodation- ability to adapt
thought to fit what is perceived
• Conservation- ability to appreciate
that a change in shape does not
necessarily mean a change in size
• Class inclusion- ability to understand
that objects can belong to more
than one classification
 Personality and Temperament
  They enter the stage of preconventional
reasoning
 They concentrate on niceness or fairness
 The distinction between right and wrong
becomes more important to them
 They are rule-oriented, when they pray
they expect their God to follow rules also
 Because they are still limited in their
ability to understand other’s views,
they may interpret something as
being right because it is good for
them, not because it is right for
humanity as a whole
 Communication
 They talk in full sentences, using language
easily and with meaning
 They no longer sound as though talking is
an experiment but appear to have
incorporated language easily
 They still define objects by their use: a key
is to unlock a door; a fork is to eat with
 Most of them can tell the time in hours, but
they may have trouble with concepts such
as half past and quarter to, especially with
the prevalence of digital clocks
 They know the months of the year and can
name the months in which holidays fall.
 Much of a child’s talk is concerned with
these concepts as he or she practices them
and shows them off for family and friends
 By age 9, they discover dirty jokes and
share them to friends or try to understand
those shared by adults
 By 12 years, a sense of humor is apparent
 Emotional
 Developmental task: Industry versus
Inferiority
 They tend to learn a sense of industry and
accomplishment-learning how to do things
well
 They have the ability to trust others and
with a sense of respect of their own worth
 They can accomplish small task
independently because they want to be
independent
 They should have mimicked adult roles and
had the opportunity to explore at
preschool or other social environments
 They should have learned to share, to have
discovered that learning is fun and an
adventure, and to have learned that doing
things is more important and more
rewarding than just watching things done
 Play
 Play continues to be rough; however, when
children discover reading as an enjoyable
 activity that opens doors to other worlds,
they will begin to spend time with books
 By age 7, they require more props for play
than they were younger
 They also develop a an interest in
collecting items e.g. baseball cards, dolls,
rocks, marbles
 8-year olds like table games but hate to
lose, so they tend to avoid competitive
games
 By age 9, they enter a phase of reading
comic books, they play hard
 They begin music lessons for children
 At 10-years old, they spend most of their
time playing handheld or television
remote games; they tend to have interest
in rules and fairness
 By 11 and 12 years old, they enjoy dancing
to popular music and playing table games
 Diagnosis:
 Health-seeking behaviors related to normal
school age growth and development
 Readiness for enhanced parenting related to
improved family living conditions
 Anxiety related to slow growth pattern of child
 Risk for injury related to deficient parental
knowledge about safety precautions for a school-
aged child
 Planning and Implementation for Health
Promotion:
 School Age Safety
 They are ready on their own without direct
adult supervision
 By age 8 and 9, many children stay by
themselves after school
 As with adults, accidents tend to occur
when children are under stress
 Sexual abuse is an unfortunate and all-too
common hazard for children
 Nutrition Health
 Most school age children have good
appetites, although any meal is influenced
by the day’s activities.
 School age children need breakfast to
provide enough energy to get them
through active mornings at school
 Most children are hungry when they arrive
home, so snacks should be available
 As part of fostering industry, school-aged
children usually enjoy helping meals
 It is important that the increasing energy
requirements that come with this age are
met daily with foods of high nutritional
value
 School-Age child in Daily Activities
  With life centered on school activities and
friends, the school-age child needs
parental guidance for most daily activities
 Promoting Healthy Family Functioning
 At 6 years of age, most children have
passed through a preschool phase of
attraction for the parent of the opposite
sex and identify again with the parent of
the same sex
 To their parent’s annoyance, many 6-year-
olds often quote their teacher as the final
authority in all subjects
 Parents often must be reminded that even
the simplest tasks of everyday life require
repeated practice before they can be
accomplished well
 Parental Concerns related to normal
development:
 Dental Caries
 School aged children usually have cavities
due to excess eating of sweets.
 It is important to teach them the proper
way of brushing their teeth, also, making
the brushing a fun experience, three times
 Language Development
a day! Some children may have to wear
special dental correctors such as braces,
with special types and ways to brush, be
sure to teach the child the right way to
brush them.
 Malocclusion
 While about 90 percent of school-aged
children have some degree of
malocclusion, only about 10 to 15 percent
of these have severe malocclusion that
requires treatment.
 The upper jaw in children matures rapidly
in early childhood along with skull growth,
the lower jaw forms more slowly, which
forces teeth to make a prolonged series of
changes until they reach their final adult
alignment and position
 Children who suck their thumbs or fingers
beyond the age of 5 have an increased
chance of developing malocclusion.
Children with a very small space between
their primary teeth (baby teeth) are at risk
for having problems with malocclusion
when their permanent teeth appear,
because the permanent teeth are larger
and require more space.
 Good teeth occlusion is necessary for
optimal formation of teeth, health of the
supporting tissue, optimal speech
development, and what most people view
as a pleasant physical appearance for high
self-esteem
 They talk in full sentences, using language
easily and with meaning
  They no longer sound as though talking is
an experiment but appear to have
incorporated language easily
 They still define objects by their use: a key
is to unlock a door; a fork is to eat with
 At age 6, they have limited ability to
understand complicated language
structures. From ages 6 to 10, children
gradually begin to think in more complex
ways. This growth enables them to
understand and use the nuances and
subtleties of language.
 Most of them can tell the time in hours, but
they may have trouble with concepts such
as half past and quarter to, especially with
the prevalence of digital clocks
 They know the months of the year and can
name the months in which holidays fall.
 Much of a child’s talk is concerned with
these concepts as he or she practices them
and shows them off for family and friends
 By age 9, they discover dirty jokes and
share them to friends or try to understand
those shared by adults
 By 12 years, a sense of humor is apparent
 Common Fears and Anxieties
 Anxiety related to Beginning School:
Adjusting to grade school is a big task for 6
years old. Even if they attended preschool,
grade school is different: the rules are
firmer and the elective feeling is gone
 School Phobia: Fear of attending school;
children who resist attending school this
way may develop physical signs of illness,
such as vomiting, diarrhea, headache or
abdominal pains on school days.
 Home Schooling
 education of children at home, typically by
parents but sometimes by tutors, rather
than in a formal setting of public or private
school. Homeschooling is a legal option in
many places for parents to provide their
children with a learning environment as an
alternative to publicly-provided schools.
Parents cite numerous reasons as
motivations to home school, including
better academic test results, poor public
school environment, improved
character/morality development, and
objections to what is taught locally in
public school. It is also an alternative for
families living in isolated rural locations or
living temporarily abroad.
 Latchkey Children
 Schoolchildren who are without adult
supervision for part of each weekday.
 The term alludes to the fact that they
generally carry a key so they can let
themselves into their home after school
 A major concern is that latchkey key
children can feel lonely or have an
 increased tendency to have accidents,
delinquent behaviors, alcohol and
beginning drug abuse, and decreased
school performance from lack of adult
supervision.
 Sex Education
 It is important that school aged children be
educated about pubertal changes and
responsible sexual practices so they are
well prepared for these.
 Preteens should also have adults whom
they can turn to for answers to questions
about sex
 Ideally, these should be parents, but
because sex is an emotionally charged
topic, some parents may be extremely
uncomfortable discussing it with their
children. As a result, health care personnel
often become resource persons.
 When your school-age child inquires about
sex, ask what he or she already knows.
Correct any misconceptions, and then offer
enough details to answer the specific
questions. Don't laugh at your child's
questions or use nicknames for your child's
sexual anatomy, which may send the
signal that these body parts shouldn't be
discussed.
 Stealing
 Stealing occurs because although the child
is gaining an appreciation for money, this
appreciation is not yet balanced by strong
moral principles.
 This usually happens at around 7 years of
age, when children are first learning how to
make change and discovering the
importance of money. Stealing is one of
the most common acts that children get
involved in, especially during their school
life. Some do it consciously. Most of them
seize other people’s belonging
unconsciously. At this age, children cannot
differentiate between their things and
those of others and hence, steal. The act of
stealing, which has become a prevalent
child behavior problem, is an immediate
concern for parents. But before taking any
corrective steps, they must try to find out
the reason why their child is indulging in
such a behavior. There are several facts
that compel children to steal, such as low
self-esteem, peer pressure, etc. It might
also be possible that they do not have
friends and are trying to ‘buy’ their friends.
 Violence and Terrorism
 Children basically view their world as safe,
so it is a shock to them when violence such
as at school shooting or international
terrorists enter their lives
 Children at this age tend to imitate and
follow what they see on the TV. It is
important to filter the shows the child
watches so as to prevent them from
following the violent actions.
 Bullying
  A frequent reason that school-aged
children cite for feeling so violent that they
turn guns in fellow classmates is that they
were ridiculed or bullied to the point they
could no longer take such abuse
 Some children bully others, either because
they want to feel more superior, to get
attention, or because it is the type of
environment they live in. It’s best to talk to
them about his and tell them that this
should not be tolerated. Immediate action
must be made.
 Recreational Drug Abuse
 Because alcohol and inhalants are
available in so many homes and often can
be purchased in small stores without proof
of age, these are the commonly abused
drugs of this age group.
 Some become addicted to glue, thus this
may cause physical effects in the future
and this must be reprimanded
immediately.
 Children of Alcoholic Parents
 As many as one in five children live with an
alcoholic parent
 Such children are at a greater risk for
having emotional problems
 Alcoholism may have a genetic cause, so
children of alcoholics are more likely to
become alcoholics
 Children with alcoholic parents are prone
to abuse, may it be physical or emotional.
They may also see this as something right
and fun since their parents are doing so.
 Obesity
 As many as 50 % of school age children
are obese by body mass index guidelines
for ideal weight. Some of these children
have been overweight since pregnancy;
their prepubertal weight gain makes them
obese
 Children who are obese tend to be laughed
at or gain low self esteem from peers, and
sometimes may cause isolation and
discrimination. Nutritional teaching and
guidance should be done by parents in
order to aid the child, but do not scold the
child nor make fun of him. Instead, tell him
the good things that will happen to him/her
if they eat right and engage in sports.
Source:
Pilitterri, A., 2003. Maternal and Child Health
Nursing: Care of the Childbearing and Childrearing
family. Philippines: Lippicott Williams and Wilkins.