6-12 years a period of Industry and

Cognitive Development

The School Age ChildBegins w/loss of 1st tooth & ends

w/pubertyAverage gains:

Weight: 5 lbs/yr.Height: 1-2”/yr

Avg 6yr: 116cm (45”) – 21kg (46#) 12yr: 150cm (59”) – 40kg (88#)Slimmer, steadier, lower center of gravityLinear growth: will outgrow shoes first,

then pants & shirtsMales & females differ little in size

Prepubescence

Prepubescence – end of mid childhood; 2-year period that precedes pubertyGirls begin puberty & reach maturity ~ 1.5-2 yrs

earlier than boys Time of rapid growth; development of secondary

sex char.; wt gainGirls: breast development; pubic hairBoys: penis and scrotum enlarge; ↑ muscle

mass

Growth & MaturationSequence is progressive and predictableGirls

Thelarche (breast development) 8-12.75 yrs (caucasian); 7-11 yrs (African American)

Pubarche (growth of pubic hair) ~2-6 mos laterMenarche ~ 2yrs after breast buds appear

Boy changes occur between 9.5 & 14 yrsInitially pubic hair appears, then penile and

testicular enlargementOther: voice changes, facial hair, axillary hair Gynecomastia common but temporary (~2yrs)

Physical GrowthGirls: PHV (peak height velocity) ~ age 126-12 mos before menarche; grow ~ 2” after menarchePWV ~ 6 months after PHVPubertal delay if no breast development by age 13 or no

menarche within 2-2.5 yrs of breast developmentBoys: PHV ~ age14Boys ht & wt occur simultaneously; ceases ~ 18-20 yrsPubertal delay if no enlargement of testes or scrotal

changes by ages 13.5-14 or genital growth not complete 4 yrs. after testicles begin to enlarge

Tanner stages used during physical exams (pp 742-743)

Psychosocial DevelopmentFreud: latency period; tranquility timeErikson: Sense of industry, stage of

accomplishment; failure results in an inferiority complex

Peer approval motivating powerReinforcements and recognition provide

encouragement

Psychosocial DevelopmentSense of accomplishment involves ability to

cooperate, compete, & cope w/othersLearn value of doing things w/others to

accomplish goalsTemperament: easy; slow to warm up;

difficult may need practice sessions & role play to prepare for events/transitions

Cognitive Development (This is BIG!)Piaget – Concrete operations

use their thought processes to experience events and actions

Concrete-operational period (7-11 yrs): develop an understanding of relationships between things and ideas

Able to make judgments based on reason; “conceptual thinking”

Can use their memory stores to evaluate and interpret the present

Cognitive Development (cont)Begin to see things from another’s point

of viewMajor cognitive tasks: conservationNumbers 1st, then substance, vol lastClassification skills are BIG – love

collections of anythingLearn to tell time and manipulate

numbers (add, subtract, divide, multiply)Biggest skill: Ability to READ

Moral Development (Kohlberg)Moral Development

Development of conscience & moral standards

Age 6-7: reward & punishment still rulesOlder: moves to judging an act by

intentions that prompted it rather than just consequences

Begin to see other’s pt of view so are able to understand concept of treating others as they would like to be treated

Language DevelopmentLanguage Development: complex

Improved grammar & word usageEnjoy jokes, riddles, puns Begin to understand metaphors &

figurative statementsBegin to evaluate and clarify messages

Social DevelopmentIdentify with peers as gain independence

from familyMore sensitive to social norms and pressures

of the peer groupSex-role learning becomes more important

with same sex peersHaving “best friends” a very big dealBelonging to a group very imp.; group rules

can be very rigid

Social DevelopmentParents still primary influence in shaping

their personalities, setting standards for behavior and setting value systems

Still need and want parental control and feel secure knowing there is an authority to implement controls and restrictions

Need firm, secure parental interest and concern, not just a “pal”

Body Image Acutely aware of their own bodies compared

to others Body integrity important

Concern re: threat or injury to it Need reassurance about both the

uniqueness and sameness of their body If different, may be excluded from groups When teased or criticized abt. being

different, effect can be life long & lead to feeling inferior

Perceptions of DeathMost realize death is final, universal &

inevitable by age 9-10Believe they may die but only in distant

future; if faced w/death feel loss of controlFear pain associated with deathMay feel guilt and responsibility about

someone’s death – need logical, factual explanations

Chronic IllnessIf can’t develop sense of achievement as a

result → feel inadequateInvolve in own care and decision makingIf feel different – may try to hide itGive factual info in simple termsHelp with school transitionsNeed alternative activitiesCamps for children w/similar challenges

Self EsteemHow they view their worth in both pos &

neg qualities is based on feedback they receive

Adults can make them feel special & successful – shaping self conceptEmphasize strengths & positive aspects of

behaviorTeachers, parents, coaches, etc – big influence

Positive self concept leads to feelings of self-respect, self-confidence, happiness

SexualityMany experience some sort of sex play out of

curiosity prior to adolescenceUsually transitory; this should be taken as an

opportunity to talk about sexuality; to provide info; use correct terminology; be concrete

Ideal time for sex ed presented as normal part of growth and development

Provide info on AIDS and dispel myths

PlayBelonging to a club or team is importantRules can be extreme and made upConformity and ritual are part of the playTeam play to attain a goalLearn about nature of competitionLearn rules, make judgments, plan

strategies, learn interdependenceComplex board, card, & computer gamesCollections

DisciplineNow able to understand the effects of their

actions on othersReasoning is an effective techniqueProblem solving is best and children can be

included in the processOthers: withholding privileges, requiring

recompense, imposing penalties, contracting

Dishonest BehaviorLying: all lie sometimes; often d/t role

modeled behaviorCheating: most common 5-6 yr; usually

disappear as matures; role model imp.Stealing: bet. 5-8 yrs sense of property rights

is limited; may steal and lie about it or may steal to make up for love or something else they may be lacking

StressOther concerns: stress (more than previous

generations); exposure to violence; school environment; pressures to excel; being over programed by parents; worries about home problems (more divorce), expected to be more mature, Latchkey Children (see p. 665)Box 17-1; p. 663 excellent summary re:

common stresses for different ages

Health PromotionIdeal time to take responsibility for their

health by end of middle childhoodSelf-care in hygiene, nutrition, exercise,

recreation, sleep, and safetyHealth education can help them learn abt

their bodies; how their beh affects their health; helps them make good decisions

Teach them to take active role in relationships with health care providers

NutritionJunk food more available – fill up on empty

caloriesSchool lunch – parents don’t know what child

really eats even if send own lunchSchool lunch and breakfast program help

meet needs of kids but often are high in fatIncrease in obesity; increase in sedentary

activitiesFast food – major contributor to obesity

Sleep and RestAmt. is individualized; ~ 9 ½ hrsNeed routine and firm bedtime; should not be

used as punishmentSleepwalking: 1st 3-4 hrs of sleep – no

memory; not purposeful; leave alone unless in danger; self limiting

Sleep talking- non purposeful; no harmNightmares: less common; chronic-refer

Physical ActivityFewer resources for PE, playgrounds and

after school programs at schoolsOnly IL requires requires daily PE from K-12 TV: kids have become less active; 26%

4hrs/day; 67% 2hr/dayViolent TV – increase in aggression, feel

desensitizedVideo games: critics violence, tension,

sleeplessness, others improve eye-hand coord.

Dental HealthFirst permanent teeth by 6yrs 3rd permanent molars (wisdom) 18-25 yrsUp until 2nd grade dexterity to properly

brush isn’t there so need supervisionBedtime brushing esp. importantFlossing done by parents til ~ 8-9Malocclusion – may need orthodontic txDental evulsion: replacement or

reattachment

Evulsed ToothHold by crown – do NOT touch root areaRinse if dirty under running water or salineReinsert and hold in place – TransportReplace within 10” if possible

If within 30”, 70% chance of successIf transport tooth, use saliva, milk, or saline

(contact lens solution) – NOT WATER!

InjuriesReflect their developmental stage p. 744Risk Taking: Peer pressure begins so risk-

taking injuries increaseMVA: most common cause of accidental

injury and deathPedestrian deaths 2.5x more freq w/ peak

incidence 5-9yrsATV’s responsible for significant # injuries

for children under 16

Injuries (cont)

Bike: 500,000 ER visits, 900 deaths annually; deaths caused by head injuries

Skateboards, rollerblades, Ride-on mowers, trampolines, flipping, horseback riding, sledding

School: most injuries on the way to & fro Guns: firearm deaths <15 yrs, ~12x

greater than 25 other industrialized countries

That’s it!Aren’t School age kids some of the coolest?? !!