LPN 124 Pediatrics Chapter 19 LEIFER THE SCHOOLAGE CHILD Spring 2004

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LPN 124 Pediatrics Chapter 19LEIFER THE
SCHOOL-AGE CHILD Spring 2004

• GLYNDA HARDIN RN MSN

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The School-Age Child

• 6-12 years
• Physical growth
• Gains 5 1/2-7 pounds per year
• Grows 2 inches per year
• Boys taller and heavier than girls until changes
  indicating puberty

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PROMOTING OPTIMUM GROWTH AND DEVELOPMENT

• This period begins with entry into school and
  shedding of deciduous teeth
• School-age ends with the beginning of puberty and
  completion of permanent dentition (w/ wisdom)
• Begin to loose primary at age 6.
• Stomach capacity increases, caloric needs are
  less than preschool

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General Characteristics

• More engrossed in fact than fantasy
• Develop first peer relationships out of home
• With increased contact with world, cognitive
  abilities, begin to understand how others
  evaluate them.
• Sense of industry development of positive
  self-esteem directly influenced by peer group
  acceptance and meeting challenges
• Able to pay attention (45 min attention span)
• Ardent thirst for knowledge and accomplishment

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Psychosocial Development

• Stage of industry
• Child needs opportunities to be successful to
  avoid development of sense of inferiority
• Childs world expands beyond the family
• Sense of belonging to a group important
• Prefers same-sex friends

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Concepts

• School age children develop a sense of industry
  or accomplishment according to Eriksons Theory.

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Psychosocial Development

• Developing a sense of industry (Erikson)
• believed to establish work attitude during this
  period
• sense of industry or a stage of accomplishment is
  achieved between 6 years and adolescence
• develop skill
• participate in meaning an socially useful work
• Failure to achieve inferiority

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Psychosocial Development

• Developing a sense of industry (Erikson)
• get satisfaction from being able to master their
  environment and interact with peers
• skill development creates an atmosphere allowing
  success in social activities
• encouraged through grades, rewards and privileges
  

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Psychosocial Development

• Developing a sense of industry (Erikson)
• also involves developing the ability to
  cooperate, compete and cope with others
• peer approval is a strong motivator

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Psychosocial Development

• Developing a sense of industry (Erikson)
• children want and need real achievement
• they need tasks that they can accomplish and
  rewards for accomplishment

THEY NEED TO BE ABLE TO DO IT AND DO IT WELL
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Freud

• In a period of sexual latency
• Repression of sexuality makes possible to from
  same sex friendships,
• Heavily influenced by parents and teachers, who
  can boost self-image, or more deeply repress
  sexuality
• Romantic love for parent of oppoosite sex
  diminishes, identify with parent of same sex.

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Self-Esteem

• Between 6-12 yrs, self-esteem very important to
  developmental process
• Children evaluated by their social contribution
  or performance (ability to achieve good grades,
  hit a home run)
• Their feelings about themselves are very
  important and should be evaluated
• Erickson states, by learning to be productive and
  accepted , gains positive self-concept

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Cognitive Development (Piaget)

• During the school years, children enter the stage
  of concrete operations
• able to use thought processes to experience
  events and actions( can focus on more than one
  thing at a time)
• able to see things from anothers point of view
• understand relationships between things ideas
  (cause and effect)
• Capable of abstract reasoning, but thought is
  still limited to his or her own experience

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Cognitive Development (Piaget)

• During the school years, children enter the stage
  of concrete operations
• develop classification skills
• group and sort according to similarity
• plays things in a sensible and logical order
• begin to order friendsbest friend
• understand relational terms and concepts
• more/less, bigger/smaller etc.
• learn symbols
• alphabet and reading.most significant skill

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Cognitive Development

• Concrete operations
• Thinking is logical
• Understands cause and effect
• Able to see other persons point of view

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Social Development

• Most important socializing agent is peers
• Identification with peer is strong influence in
  gaining independence from parents
• most of the concept of appropriate sex roles is
  learned through peer relationships

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Social Development

• Relationships with families
• parents are the primary influence in shaping
  childs personality, setting standard and
  establishing values
• discover parents can be wrong
• begin t question knowledge and authority of
  parents

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Social Development

• Clubs and peer group formation is one of the
  outstanding characteristics of middle childhood.
• Rigid rules
• exclusiveness
• acceptance
• conformity

Provides a sense of security and relieves them of
some heavy responsibilities such as decision
makingmoving away from family as a step toward
independence.
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Social Development

• Play.. Rules Rituals
• need for rules is realized
• rigidity
• conformity and rituals
• chants and taunts
• give pleasure and power

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Spiritual Development

• Beliefs of family more influential than peers
• God is viewed with human characteristic
• fascinated with concept of heaven/hell
• fear going to hell as punishment
• want and expect punishment for misbehavior
• view illness/injury as punishment
• comforted by rituals such as prayer etc

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Concepts

• Major elements of play during the school age
  years involve
• cooperative play
• team sports and activities
• skill acquisition
• Following rules and rituals become more important

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Sex Education

• Nurses role in sex education
• sex should be treated as a normal part of growth
  and development
• answer questions honestly, and matter-of -factly
• keep answers at the childs level
• Preadolescents need precise and concrete
  information
• tell them what they want to know about and what
  to expect as they mature

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Concepts

• The conscience develops during the school age
  period
• better able to understand and follow rules and
  standards established by someone other than
  themselves

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Moral Development (Kohlberg)

• Developing conscience and moral standards
• ages 6 or 7 know the rules and expected behaviors
  but do not understand reasons behind them
• rewards/punishments guide judgments
• believe accidents or misfortunes are punishments
  for disobeying or being bad

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Nutrition

• caloric needs are less
• variety of foods increases
• caution with junk food lacks nutrients needed for
  adequate growth and may lead to obesity due
  starches and fat consumption

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Biologic Development

• Growth is slow but steady
• increase an average of 2 inches/year
• gaining 1-2 feet over all in height
• Weight will almost double
• weight gain averages 4.5 - 6.5 lb./year
• Girls outgrow boys in size toward end of this
  period with both groups starting out basically
  equal

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Injury Prevention

• School age children have more refined muscular
  coordination as well as cognitive capacities
  thereby decreasing incidence of injuries
• Riding bicycles on streets and byways increases
  risk of injuries
• most injuries occur near home or school

most common cause of severe injury and death is
MVA