Growth and Development: School-Age Child

Question 1

School-Age Child Periods

Answer 1

• Early Childhood: 5-7
• Middle Childhood: 8-10
• Late Childhood: 11-12

Question 2

School-Age General Considerations

Answer 2

• 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

Question 3

Approach to the School-Age Assessment

Answer 3

• 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

Question 4

School-Age Health Hx

Answer 4

• 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

Question 5

School-Age ROS

Answer 5

• 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

Question 6

School-Age PE

Answer 6

• 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

Question 7

Tanner Stage: Female Breasts

Answer 7

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

Question 8

Tanner Stages: Female Pubic Hair

Answer 8

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

Question 9

Tanner Stages: Male Genitalia

Answer 9

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

Question 10

Puberty: General Guidelines - Female

Answer 10

• 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

Question 11

Puberty: General Guidelines - Male

Answer 11

• 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

Question 12

Pediatric Symptom Checklist (PSC) - A Developmental Tool

Answer 12

• 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

Question 13

6-7yr: PE Findings

Answer 13

• 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

Question 14

8-9yr: PE Findings

Answer 14

• 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

Question 15

10-12yr: PE Findings

Answer 15

• 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

Question 16

Girls are, on average…

Answer 16

2 years ahead of boys