2. Growth and Development
Overview
• Spans age 6-12 years
• Begins with shedding of first
deciduous tooth ends with
puberty and final permanent
teeth.
• Height and weight, slower
but steady pace
• Caloric needs decrease
• Organ growth matures
3. PHYSICAL GROWTH
• Body systems mature
• Average school age child grows
• 2.5 inches ( 6-7cm.) per year
and 7 lbs (3-3.5 kg) per year
In early school-age, boys and girls
height and weight are similar. In later school age
years, most girls surpass boys in height and weight
4. Prepubescence/Preadolescence
• Late school age years
• Occurs 2 years before puberty
• Characterized by the development of 2nd sex
characteristics, a period of rapid growth for girls
and continued growth for boys.
• Early development vs. delayed development
5. Nutrition
• Caloric needs diminish
• Need well balanced diet
• Food preferences set
• Pattern based largely upon family’s
• “Junk food” / Peer influence
TEACHING/PREVENTION
• Nutrition education/ School Nurse
• Oral health ( dentition, cavities)
http://www.youtube.com/watch?v=08HVcfxRg-k&feature=related
7. Obesity Trends* Among U.S. Adults
BRFSS, 1990, 1999, 2008
(*BMI ≥30, or about 30 lbs. overweight for 5’4” person)
1990 1999
2008
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
8. Prevalence of Obesity* Among U.S. Children and Adolescents
(Aged 2 –19 Years)
National Health and Nutrition Examination Surveys
*Sex-and age-specific BMI > 95th percentile based on the CDC growth charts.
10. OBESITY PREVENTION
Healthy People 2020
1. Diet Nutrition/School based programs
limit sugared/sweetened drinks
eliminate foods of low nutritional value, free
water available.
2. Increase physical activity: limit, screen (TV, computer)
time, set a required # minutes spent in
physical activity.
Screen all children for development of overweight as
indicated by BMI for their age.
3. Policy and environmental changes
14. Erikson – Industry vs. Inferiority
• Goal is to achieve a sense of
competence, mastery and success
• Intrinsic motivation increases with
competence in mastering new skills
• Expectations of adults too high, child
will develop a sense of inferiority and
incompetence.
• Children with mental/physical
limitations at risk
15. Piaget – Concrete Operations
• 7-11 years progress from what they see
(perceptual thinking) to what they reason
(conceptual thinking)
• Decrease in egocentricity
• Reversibility
• Principles of Conservation
• Classification of objects
16. Kohlberg –Moral development
• The school age child is at the conventional
stage of moral development. 7-10 year olds
are in stage 3, Interpersonal Conformity
“Good Child/bad Child) Adults are Right.
17. Kohlberg –Moral development
• • 10-12 year olds progress to the “law and
order stage” actions are good or bad, based
upon the reason not just consequences.
Actions are guided by cooperation and
respect for others
• Spiritual Development becomes more
important
18. Gross motor skills/ Fine Motor Skills
Gross Motor: Fine Motor
Bike riding Writing
Jumping rope Musical
Swimming Instruments
Ball game skills Constructing
Refinement of motor skills occur
models
18
19. Language
• Vocabulary expands. Reading skills
improve.
• Bilingual children may speak English
at school, primary/secondary
language at home.
• Experiment with profanity, role
modeling important
19
20. Social Development
• Explore environment
beyond family
• Parent’s influence still primary
• Peer approval
• Same sex friendships
• Question parent’s values
• Formalized groups or “Clubs”
• Bullying, Gang Violence
● Follow rules, judge those who
do not
21. Play/Peers
• Cooperative Play/ Team Play/Skill
development
• Sports, Debate Team, Spelling Bee
• Importance of group goals, dividing tasks
• Nature of Competition
• Stimulation of cognitive growth
• Complex board games, computer games and
reading for pleasure
23. Self Concept/Body Image
• School-age children
-knowledgeable
about human body
• Acceptance of body
parts, changes?
• Successes impact self
esteem
• Sexuality- Ideal time
for formal sex
education
24. Reaction To Hospitalization
• Fear loss of control,
abandonment and
death.
• Fear procedures, pain,
and outcomes, as
opposed to the
preschooler’s fear of
equipment and
surroundings.
25. Pre-admission Preparation
• School Age- ideal
age for advanced
preparation
• Tours
• Classes
• Booklets
• Discussion with
honest answers
26. Interventions To Promote Coping
• Encourage questions /discussion
• Use diagrams, models, and equipment to
supplement explanations
• Encourage participation in care
• Encourage parent involvement/stay
27. Interventions To Promote Coping
• Use books, games, role play to work
through feelings and to prepare child for
procedures.
• Promote contact with family, friends
school
29. Pain Assessment
• Subjective “self report” is best
1. Assess using Pain scale
Faces 0-5
2. Visual analog Pain Scale 0-10
• Behavioral scales and observations important for
child with cognitive impairment
35. Special Problems
• Limit Setting – Discipline
• Withholding privileges
• Contracting
• Problem solving with child
• Dishonest Behavior
• Lying
• Stealing
• Cheating
36. Special Problems
• Stress – Over programming
• “ Hurried Child” ( Elkind)
• “ Latch Key” Children
• Fears/Worries – school/peers/family
• Violence
• Failing feeling “stupid”
• Not being accepted by peers
• Changes in family structure
• Too many adult responsibilities
• http://www.guardian.co.uk/society/video/2009/feb/18/worried
-smoking-children
37. Anticipatory Guidance
• Injury Prevention/Safety
Independence → self confidence
→ accidents and injuries.
Exposure to danger
Bike safety/helmet safety
Seat belts/rear seat
Pedestrian safety
Sports safety
Fire safety
Water safety
Firearms safety
These 3 maps of the US representing 1990, 1999, and 2008 show the tremendous increase in the prevalence of obesity. It is estimated that 1/3 of adults in the US – and 16% of children are obese. The rate of obesity since 1980 has doubled in adults and tripled in children.
The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews and physical examinations. The survey examines a nationally representative sample of about 5,000 persons each year. These persons are located in counties across the country, 15 of which are visited each year. Another source of data, is the Youth Risk Behavior Survey (YRBSS) which is conducted every 2 years and it monitors 6 categories of priority health-risk behaviors among youth; two of which are unhealthy dietary behaviors, and physical inactivity. There are state specific info r/t the results of this survey on the CDC website. According to YRBSS (2007), only 53.6% of students had PE classes, 35.4% watched TV for > 3hrs per day, 13% were obese, 15.8% were overweight, 21.4% had eaten fruits and vegetables 5 or more times a day, and 33.8% had drank soda at least once a day.
Know the facts . Health promotion : Educate children and their families. Be culturally and socially sensitive . Be aware of resources in the area you practice.
Policy affects a much larger group therefore, it’s a more efficient way of making change. There are many examples of important public health victories in the US: Reduction in lead exposure Motor Vehicle safety Tabacco regulations: reduction in rates of smoking Increased vaccination rates Some examples of policies in different states: Minnesota: state graduation standards include physical activity. Maine: a significant portion of the tobacco settlement funds are being used to support “healthy Maine Partnerships”. The state employs school health coordinators to promote physical activity, nutrition,…. In Los Angeles , CA: Sale of soft drinks are banned in all school districts. In Michigan: “Building Healthy Communities” project was designed to improve the environment and change policies to make it easier for residents to be healthy. Some of the achievements were, conducting 129 community fitness classes, providing residents with walking maps, coupons to low-income families to redeem for fruits and veggies, and creating community and school gardens. sliding scale fees for gyms/parks and rec classes, schools offering their gym spaces to the community) and good nutrition (corner stores stock healthier foods, incentives/grants for stores to make infrastructure changes to offer healthier foods)
Referral for speech problems. Definitions, in the sense of dictionary definitions
