Growth and Development: School-Age Child Flashcards
School-Age Child Periods
- Early Childhood: 5-7
- Middle Childhood: 8-10
- Late Childhood: 11-12
School-Age General Considerations
- Busy, active, curious, vocal
- Can function in more structured environment (School)
- Advanced physical abilities, sports
- Engages in peer relationships
- Masters intellectual skills
- Develops awareness of others’ feelings
- More sophisticated social skills
- Become negotiators
- develop a sense of belonging to a community
- Patterns of NL growth have broad parameters
Approach to the School-Age Assessment
- Introduce yourself directly to the child FIRST
- Ask the child who is with him/her today
- Shake hands if the child is willing
- Ask age appropriate questions directly to the child and give time for answers
- Explain what you plan to do with the child prior to carrying out the assessment
School-Age Health Hx
- Include age appropriate discussions including:
- Strangers and inappropriate touch
- Hygiene and body image, dress, modesty
- Progressive, age appropriate decisions concerning cigarettes, ETOH, drugs, gangs, sexual abstinence, risk of sexual activity, protection of STIs, Birth control
School-Age ROS
- Subjective data received directly from child
- Pay attention to both child/parental concerns on puberty
- Be alert to ANY PARENTAL CONCERNS about behavior or school performance
School-Age PE
- Continue to plot stats on charts
- Expect changes in VS and compare to NL for age
- NL stages of puberty including Tanner Stages in M/F
- In F: includes breasts (thelarche), pubic hair (adrenarche), and genital development
- In M: Includes pubic hair and genital development
Tanner Stage: Female Breasts
1) Prepubertal: No palpable breast tissue
2) Breast bud
3) Further enlargement of breast and areola
4) Projection of areola
5) Adult-like with areola recessed to contour of breast
Tanner Stages: Female Pubic Hair
1) No pubic hair
2) Sparse pubic hair, straight, on labia
3) Pubic hair coarser, darker, curled over pubic bone
4) Adult-like, not on thighs
5) Adult distribution
Tanner Stages: Male Genitalia
1) Prepubertal
2) Scrotum and testes larger; penis same size; sparse pubic hair
3) penis larger; pubic hair coarser, curly, to pubis
4) Penis, testes, scrotum larger; hair not on thighs
5) Adult-like hair on thighs
Puberty: General Guidelines - Female
- Average age of breast bud development is 9-13, but may be as young as 6, depending on ethnicity; generally asymmetric.
- Usually pubic hair develops 6mo after breast buds; sometimes it is prior to breasts
- Average age of menarche is 12.5, but may be as young as 9-10, depending on ethnicity and nutritional factors
Puberty: General Guidelines - Male
- Growth of testes starts 6mo prior to pubic hair; left testis usually hangs lower than right
- Testicular enlargement always precedes other changes (if not ? anabolic steroids)
- Sperm (spermarche) starts between 13.5-14.5
- Axillary, facial, body hair appears at Tanner stage IV in that order
Pediatric Symptom Checklist (PSC) - A Developmental Tool
- Psychosocial screen for 6-16
- Recognizes cognitive, emotional, and behavioral problems for early intervention
- Consists of 35 questions that are scored as 0, 1, & 2 for never, sometimes, and always
- The cutoff is 28; anything higher than this reflects psychosocial impairment and the need for further evaluation
- Can be used as young as 4-5, but abnormal score is lowered to 24 in this group
- Contains a Y-PSC (Y=Youth) completed by age 11+; scoring for this set at 30+ is abnormal
- If 4+ items are blank, the screen is invalid
6-7yr: PE Findings
- Communicaton: competely intelligible language, full understandable sentences; doubles vocabulary
- Gross motor: hops, jumps, skips, catches ball, coordinated activity/sports; test muscle strength
- Fine motor: adult-like pencil grasp; draws all shapes; complete body (8 parts); ties shoes
- Problem solving: can complete school work; longer attention span; may reverse letters; writes words; likes to build things
- Social: makes friends; plays interactive sports; shows interest in rules
8-9yr: PE Findings
- Communication: reads books, stories; relates the story to a listener in detail
- Gross motor: walks in straight line; coordinated; strong with endurance; good sense of balance; a little “gawky”
- Fine Motor: writes sentences; copies a diamond; draws a person (16 parts)
- Problem solving: days of week; adds; subtracts; knows right and left; tells time
- Social: hobbies; likes animals; best friend and best enemy; enjoys group activities
10-12yr: PE Findings
- Communication: Reads fluently; likes reading magazines; how-to projects
- Gross motor: increase in body strength; improved coordination
- Fine motor: easily writes in cursive; improved hand dexterity
- Problem solving: improved coordination and reaction time; likes games with more complex rules; higher level math; trouble following rules
- Social: more goal oriented; develops special hobbies; friendships very important