1. Chapter 19
The School-Age Child

2. Objectives
• Describe the physical and psychosocial
development of children from 6 to 12 years of
age, listing age-specific events and type of
guidance where appropriate.
• Discuss how to assist parents in preparing a
child for school.
• List two ways in which school life influences
the growing child.
• Discuss accident prevention in this age
group.
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3. Objectives (cont.)
• Contrast two major theoretical viewpoints of
personality development during the school
years.
• Discuss the role of the school nurse in
providing guidance and health supervision for
the school-age child.
• Discuss the value of pet ownership for the
healthy school-age child and the family
education necessary for the allergic or
immunocompromised child.
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4. General Characteristics
• Ages 6-12 years
• More engrossed in fact than fantasy
• Develop first close peer relationships outside
the family group
• Often judged by their performance
• Sense of industry and development of
positive self-esteem directly influenced by
peer group
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5. General Characteristics (cont.)
• Progress from the skill of writing or reading to
understanding what is written or read
• Must work toward a delayed reward
• Parents need to be guided to understand that
multiple unsuccessful experiences can lead
to the development of a fear of trying
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6. General Characteristics (cont.)
• Erikson: stage of industry
• Freud: sexual latency
• Piaget: concrete operations
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7. General Characteristics (cont.)
• Between 6 and 12 years of age
– Self-esteem becomes very important in the
developmental process
– They are evaluated according to their social
contributions
– Feelings about themselves are important and
should be assessed
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8. Physical Growth
• Slows until just before puberty
• Weight gain is more rapid than increase in
height
• Brain has reached approximately adult size
• Muscular coordination improved
• Lower center of gravity
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9. Physical Growth (cont.)
• Loss of primary teeth begins around 6 years
– Four permanent teeth erupt per year
• GI tract more mature
– Stomach capacity increases
– Caloric needs decrease
• Heart grows slowly
– Smaller in proportion to body size
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10. Physical Growth (cont.)
• Important to note
– Size is not correlated with emotional maturity
– Problems can occur when a child faces higher
expectations because he or she is taller and
heavier than peers
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11. Gender Identity
• Sex role development influenced by parents
• Differential treatment and identification
– In the family
– In society
• Influence of school environment
– Aggressive behavior more accepted in boys than girls
• Incorporation of traditionally masculine and
feminine positive attributes may lead to fuller
human functioning
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12. Sex Education
• Lifelong process
• Accomplished less by talking or formal
instruction than by the whole climate of the
home
• Questions should be answered simply
• Correct names for genitalia should also be
used
• Private masturbation is normal
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13. Sex Education (cont.)
• Boys should be • Can be taught in
prepared for the context of the
erections and normal process
nocturnal emissions and function of the
• Girls should be human body
prepared for • Facts must be
menarche and provided
taught how to use
the supplies
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14. Sexually Transmitted Infections
(STIs)
• Education on how to prevent STIs and
HIV/AIDS should be presented in simple
terms
• Factual and concrete information is an
essential component
• Facts concerning harmful effects of drugs
and unprotected sex should be
communicated to the child without scare
tactics
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15. Nursing Tip
• When discussing sexuality with school-age
children, it is necessary to review slang or
street terms
• Most children hear the terms but may be
confused about their meaning
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16. Influences from the Wider World
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17. School-Related Tasks
• Children bring what they have learned and
experienced at home to school
• May be unable to verbalize needs
• Success requires an integration of cognitive,
receptive, and expressive skills
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18. School-Related Tasks (cont.)
• Holistic attitude must • Anticipatory guidance
also focus on qualities includes
such as – Review of normal
– Artistic expression physiology
– Creativity – How it changes with
– Joy puberty
– – Child is encouraged to
Cooperation
ask questions at the
– Responsibility time they arise
– Industry
– Love
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19. School-Related Tasks (cont.)
• Parents and children should set realistic
goals
• Develop heightened awareness for things
such as attendance problems, tardiness, and
signs of loneliness or depression
– Should continue to encourage children to
discuss school problems, feelings, and worries
• Homework is the responsibility of the child
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20. Play
• Involve increased physical and intellectual
skills and some fantasy
• Culture of the school-age child involves
membership in a group of some type
– Team sports, competition
– Enables the child to feel powerful and in
control
• Mastering new skills helps the child feel a
sense of accomplishment
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21. Observing Play
• Play is essential to growth and development
• Provides link between spontaneity of
childhood and disciplined adult activities
• Some elements to assess
– Motivation and intensity of engagement
– Relation to reality or creativity
– Choosing how to play
– Self-control
– Sharing
– Skills being used
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22. Latchkey Children
• Subject to higher rate of accidents and are at
risk of feeling isolated and alone
• Back-up adult should be available to the child
in case of emergencies
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23. Physical, Mental, Emotional, and
Social Development
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24. The 6-Year-Old
• Energetic and on-the-go
• Likes to start tasks, but does not always
complete them
• Talks for a purpose rather than for the sake of
talking
• Vocabulary consists of 2500 words
• Requires 11 to 13 hours of sleep per night
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25. The 6-Year-Old (cont.)
• Boys and girls play together, but begin to
prefer to associate with children of the same
sex
• Needs time and support to help adjust to
school
• Parents must observe children for signs of
fatigue and stress
• Increased exposure to infectious diseases
– Stress importance of immunizations
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26. The 7-Year-Old
• Sets high standards for themselves
• Good sense of humor
• More modest
• Enjoys being active but also enjoys periods of
rest
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27. The 7-Year-Old (cont.)
• Knows seasons and months
• Understands beginning concept of math
• Hands are steadier
• Active play still important
• Becoming more independent
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28. The 8-Year-Old
• Wants to do everything
• Can play alone for a longer period of time
• Creative
• Enjoys group activities
• Behaves better for company than for family
• Hero worship evident
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29. The 8-Year-Old (cont.)
• Arms and hands appear to grow faster than
rest of body
• Muscles better developed
• Enjoys competitive sports
• Likes to argue
• Need to teach child how to express anger in
an acceptable manner
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30. The 9-Year-Old
• Dependable
• Shows more interest in family activities
• Assumes more responsibility
• More likely to complete tasks
• More able to accept criticism for their actions
• Worries and mild compulsions are common
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31. The 9-Year-Old (cont.)
• Hand and eye coordination well-developed
• Manual activities are managed with skill
• About 10 hours of sleep are needed each
night
• Permanent teeth still erupting
• More active in competitive sports
• Important to teach proper technique and the
use of adequate safety devices
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32. Preadolescence
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33. The 10-Year-Old
• Marks beginning of preadolescence
• Girls more physically mature than boys
• Begins to show self-direction
• Wants to be independent
• Group ideas more important than individual
ones
• Sexual curiosity continues
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34. The 10-Year-Old (cont.)
• Girls more poised than boys
• Slang terms used
• Begins to identify himself or herself with skills
that pertain to the sex role
• Takes more interest in personal appearance
• Knows abstract numbers
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35. 11- and 12-Year-Olds
• Intense, observant, energetic
• May be argumentative and meddlesome
• Hormone influence on physical growth more
apparent
• Need freedom within limits and recognition
they are no longer infants
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36. 11- and 12-Year-Olds (cont.)
• Less concerned with appearance
• Seem preoccupied
• Ability to concentrate decreases
• Group participation still important
• Interested in their bodies and watch for signs
of growing up
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37. 11- and 12-Year-Olds (cont.)
• Need freedom within limits and recognition
that they are no longer infants
• Should know why parents make a decision
• Conscience enables them to understand and
accept reasonable discipline
• Will ignore constant verbal nagging
• Chores are good teaching tool for this age
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38. Guidance and Health Supervision
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39. Health Examinations
• Usually given in spring preceding school
admission
• If inattentive at school, should be screened
for vision or hearing deficits and language or
learning disabilities
• Assessment of physical activity and school
performance is important
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40. Health Examinations (cont.)
• If ill, the school-age child can understand
simple explanations of the illness
• Need time and a place to study
• Must learn to take responsibility for their
assignments and school supplies
• An allowance or at least a means of earning
money provides children with opportunities to
learn its value
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41. Pet Ownership
• Pets that have close contact with children
have the potential of transmitting disease
• Handicapped children especially benefit from
interacting with pets
• Allows the ill child who feels separated from
other people to feel companionship and
positive attitude
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42. Pet Ownership (cont.)
• Age of child, allergies, immune issues are
major deciding factors
• Infections can occur via contact with the pet’s
saliva, feces, or urine, or by inhalation or skin
contact with organisms
• Risk factors can be further reduced if children
are cautioned not to kiss pets, do not allow
animals to sleep in bed with them, and are
encouraged to perform hand hygiene
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43. Pet Ownership (cont.)
• Having an allergy to animal dander does not
always rule out having a pet
• Cats are most often the allergen offender
because the allergens are secreted in the
saliva and by sebaceous glands
• If an allergenic pet is in the home, more
frequent bathing of the animal can reduce
some of the allergens
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44. Question for Review
• Why is teaching fitness and exercises in
school important to growth and development?
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45. Review
• Objectives
• Key Terms
• Key Points
• Online Resources
• Critical Thinking Questions
• Review Questions
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