Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Chapter 9 Middle Childhood Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Definition Between the ages of 6 and 12 years Focus more on fact rather than fantasy. Major developmental tasks is forming positive self-esteem from internal sources Ability to develop close peer relationships Change from concrete thinking to abstract thinking Develop secondary sex characteristics-usually onset of puberty early in girls Accept more responsibility Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Physiological Changes Myelinization of the brain is complete Bones continue to ossify and grow Physical growth is slow during school-age Growth spurt just before puberty Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Physiological Changes (Cont.) Loss of primary teeth begins about age 6 Parents need to be aware dental checkup should be part of routine health care Importance of when to brush teeth GI tract more mature Sensory organs mature See Figure 9-1. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Exercise and Play Engage in rough-and-tumble play Competition is often a welcome challenge Organized sports can develop teamwork and physical fitness and appropriate for age and abilities Excessive pressure to win is not helpful and should be avoided See Figure 9-2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Exercise and Play (cont.) School-age children need daily physical activity Promotes a healthy body composition and bone mass Academic achievement has been linked to vigorous physical activity in children Exercised induced asthma Collecting things or playing board games are often enjoyed by the school-age child Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Growth and Development Physiological growth-average of 2 in per year in height and 5.5 to 7 lbs per year Intellectual competency Emotional-social competency Nutrition-will try to skip breakfast or meals in order to continue what they are doing Play Safety-Teach safety related to a variety of activities, sports and water activities See Table 9-1. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Cognitive Development Concrete thinkers-so will have the ability to classify things and will be able to group things so may start collections of items Understand rules Hands-on learning is the most effective educational method for school-age children Stage of industry-a desire for knowledge, to master skills, and emulate role models Social cognition-interact better with peers and can enhance their self concept; will need to learn that not everything is theirs-less egocentrism; will start to recognize others have opinions also See Table 9-2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Cognitive Deficits Cognitive deficits must be assessed early so that the child can be successful in school Table 9-3 May show problems with letters b,d, and g and may get them confused Poor handwriting See Table 9-3. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Three Phases of Moral Behavior Knowledge (logic) – Knowing what is right Emotion – Feeling good or bad about what is right Action (behavior) – Behaving according to the rule of what is right See Box 9-1. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Cognitive Styles A pattern of thought and reasoning Kohlberg believes that children develop moral reasoning when the child understands difference between right and wrong Mnemonic techniques Feelings of success encourage the child to continue making efforts Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Communication Skills Usually able to express themselves verbally Often use language as an effective communication tool Language or other communication problemscause a risk for social isolation and underachievement in school Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Intelligence Tests Stanford-Binet intelligence quotient (IQ) test-assesses the mental capabilities of the child and compares set norms or expectations for each age Wechsler Intelligence Scale-ages 6-16 Wechsler Preschool and Primary Scale of Intelligence-for children between 3-7; help predict school performance and to help identify children who may need additional help Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Psychosocial Development Psychosocial development considerations of the school-age child include Task of Industry, Peer Relationships, Latchkey Children, and Sexuality Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Task of Industry Gain satisfaction from achieving even small goals Erikson’s theory of industry will support that children of this age will carry tasks through to completion Praise is essential in this stage of development to build motivation to learn and achieve Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Peer Relationships Begin to compare family values with the values of others Friendships with same-sex peers are very important-may form clubs Divorces, family violence, and other home problems, and gang relations can interfere with a child's achievement of developmental tasks Can develop close relationships with friends and share precious belongings, thoughts, and secrets Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Peer Relationships School age children protect their possessions, value privacy, given responsibilities such as chores At times will target or ridicule others that are not the same as them-the child may suffer from low self esteem and self concept Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Latchkey Children Left unsupervised after school, because both parents work Some enjoy the independence and develop maturity and problem-solving skills Others feel isolated and may be at an increased risk for accidents or getting into trouble After-school programs See Box 9-2. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Sexuality Freud’s period of sexual latency Identify with same-sex parents Often ask questions related to sexuality and should be given honest and accurate answers Approach subject as part of growth and development Sex education is a lifelong process See Table 9-4. Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Teaching Techniques Attention span is limited to a maximum of 45 minutes Present information in a truthful, factual, and age-appropriate manner Periods of praise and occasional rewards reinforce learning accomplishments Peer attitudes can influence learning and can enhance the application of values taught Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Discipline Should be thought of as providing age-appropriate positive reinforcement of good behavior Punishment should be prompt, consistent, and fair Motivation for misbehavior should be investigated Children with attention deficit hyperactivity disorders (ADHD) are likely to misbehave unintentionally Should combine reward and punishment and should be based on age-appropriate behavior expectations Corporal punishment-can be a deterrent and cause problems loss of self esteem and depression Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.

Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc. Major Health Teaching Prevention of injury Maintenance of adequate nutrition Providing regular dental care Screening for scoliosis, vision, and hearing problems Developing an active lifestyle Copyright © 2013, 2004 by Saunders, an imprint of Elsevier Inc.