School ages (6-12 years)

Learning Guide: 6

Text Book
Kozier & Erbs Fundamentals of Nursing
concepts, process and practice. 8 th
edition.
Chapter 21
Pages: 380 383.

Biologic growth
Weight and height : Boys show a slight increase
in weight and height gain than girls.
The average gain in height and weight are:
Height gain : 4-6 cm (1.5-2.5 inches) every year.
Weight gain : 3.2 Kg / year.
Height at 6-8 yr is 110-124 cm. By 12 years it
increases to 144-160 cm.
Weight at 6-8 yr is 17.5-25.5 Kg. By 12 years it
increases to 40-42 Kg

Body proportions
Schooler appears long legged.
The center of height is steadily
changing from umbilicus to midway
between umbilicus and symphisis
pubis.

Physiological changes
Dentition
Looses primary teeth and erupts
permanent teeth. First molars come
out.
Endocrine
All functions mature except for
reproduction.

Vital signs
Pulse
9020 b/mt
Resp.
203/mt
BPmm of Hg
100/60 16/10
50% of children may have heart murmurs.

Immune system

Immunity develops against specific and

localized infections.

The amount of lymphatic tissues in the nasopharynx increases and may cause blockage
of the eustachian tube. There is a high risk
for ear infections.

As the child grows the rate of infections

decrease.

Nervous system
Matures by 10 years of age.
Sensory development
By 7 years visual acuity is 20/20.
From 8 yr to adolescence there is a
tendency for myopia (near sightedness).
Matures sense of taste and smell.
Can identify objects by touch alone.
Can locate application of heat, cold or pin
prick to the body surface.

Motor development

Masters over the previously acquired

skills. Needs regular exercise of 4-6
hours daily for normal development.

Motor development 6-8 years

Gross motor skills

Rides bicycle without training wheels.

Runs, jumps, climbs, hops.

Constantly in motion.

Improves coordination of movements.

Fine motor

Knows right from left hand.

Draws a person with 12-16 parts.

Prints words, learns cursive writing.

Improved eye-hand coordination.

Motor development 6-8 years

Feeding skills
6 years
Eat with fingers.
Stuffs food into mouth.
7 year
Improved table manners.
Grooming and dressing skills
Self care managed.
Needs to be reminded to wash hands.
Needs some help with dressing.
Wears dress selected by parents.
Leaves clothes where they are removed.
Can brush and comb hair.

Motor development 8-10 years

Gross motor

Performs tricks on bicycles.

Participate in organized sports. Eg. Foot ball

Throws a ball skill fully over hand and under

hand.
Fine motor

Uses both hands independently.

Draws a person with 18-20 parts.

Increased smoothness and speed in fine motor

control.

Prints fluently; cursive writing.

Motor development 8-10 years

Feeding skills
Handles eating utensils skillfully.
Grooming and dressing skills
Dresses self completely.
Selects own clothes.
Unaware of dirty clothes.
To be reminded to brush teeth.

Motor development 10-12 years

Gross motor skills

All physical activities.

Fine motor

Improved coordination.
Feeding skills

Criticizes table manners of parents.

Grooming and dressing skills

May wear some clothes continually.

Leaves clothes where they fall.

Enjoys current style dress.

Needs constant reminding of personal hygiene.

Psychosexual development - Freud

Latency period: The sexual tendencies
are repressed. No specific areas of sexual
pleasure. The focus is on physical and
intellectual activities and skills. During the
early latency period children associate with
same sex peers and may not like the
opposite sex.

Psychosocial development: Erikson.

Developmental task:
Industry versus inferiority.
Mastery of social interactions give them a sense
of industry and competence. Criticism and
evaluation by peers help the child in determining
success and competence.
A sense of inferiority may develop in children who
fail to separate psychologically from their primary
care givers. If the parents set goals too high for
the child or not allow them to freely interact with
peers, the child fails in attaining social skills.

Intellectual / cognitive development (Piaget)

6-7 years: Preoperational thought - Stage 2: Intuitive phase
Attention span increases.
Can describe objects in pictures, knows their use.
Develops concept of cause and effect.
Can see differences more than similarities. Eg. Can
identify the differences in two similar pictures.
Develops concept of conservation.

Both containers have the same volume.

Can tell time.
Knows date, month and season.
Learns to read.
Follows rules to avoid punishment.
Takes small objects from others (stealing).

7-11 years (Concrete operational thought)

Understands and uses abstract symbols.
Eg. Understand furniture.
Carries out mental operations. Can make
calculations in mind.
Shows interest in casual relationships.
Understands explanations.
Ashamed of failures.
Interested in school work.
Memory span increases.
Keeps time, punctual.
Rebels against authority makes complaints or
withdraws.
Makes alibis for own faults.

11-12 years
Develops abstract and deductive reasoning.
A=B; B=C;
Hence, A=C
Uses problem solving methods.
Can define abstract terms. Eg. Love
Interested in the why and how.
Short interest span.
Collects facts for future use.
Begins to think about a vocation.
Preoccupied with right and wrong.
Ethical sense more realistic than idealistic. Eg.
May tell a lie to escape from punishment.

Moral development (Kohlberg)

6-7 years
Stage 2: Preconventional level
Same as preschooler. Egocentricity. Doing good to
avoid punishment.
7-9 years
Stage 3: Conventional morality.
Correct behavior is that which is approved by the
authority. Conforms to rules to please others. Also
conforms to group norms.
9-12 years
Stage 4: Conventional morality.
Maintenance of social order. Look to the rules and
law for guidance and decision making.

Spiritual development Fowler

Mythic Literal Faith stage
They learn many things about their
religion. They develop a religious
philosophy and interprets the world
based on this philosophy. But later in
adolescence they may drop these
philosophies or continue it.

Characteristics of development of
school age children
6-8 years
Has a know it all attitude.
Craves attention.
Insists on being first in everything.
Returns temper tantrums verbal / physical
attacks.
Uses tension releases-chewing in hair, nose
picking.
Has good days and bad days.
Wants other children to play with.
Jealous of siblings.
Fears bodily injuries.

8-10 years

Curious about everything.

Concerned about relationship with others.
Becoming peer oriented.
Easy to get along at home.
Begins hero worship.
More importance to peer opinions.
Helps in household activities.
Take care for siblings.
Aware of appropriate sex role.

10-12 years

congenial, sincere, confident.

Has self control.
Respects parents.
Has short bursts of anger. By 12 year,
able to control anger.
Joins groups formal and informal.
Hero worship.
Fears the dark.
Knows about sexual relationships.

Play behavior
Loves active play
Prefers group play
Types of toys:
Table games, board games.
Bicycles, jumps ropes, punching bags, roller
skates, balls/bats, gymnastic equipments.
Puppets, dolls, paints, crayons, drawing materials,
clay, magic tricks, dance lessons, musical
instruments, books, puzzles, records, tapes.
Collectables-stamps/coins.
Pets.

Developmental problems
Psychological and social
Regression: Behaving like a younger age child.
Malingering: Pretending to be ill.
School problems
Rationalization: Justifying ones own actions
Ritualism: Very particular in certain acts
Learning disorders
Sibling rivalry
Cruelty
Finger sucking
Nail biting
Teeth grinding
Tics
Stealing
Lying

Health problems

Infections
Dental caries
Visual/hearing deficits
Accidents
Smoking
Drug abuse

Health promotion and

anticipatory guidance
Methods
Health information to the school
children.
Preschool health examination.
School health programs.
Health fairs.

Health promotion
Nutrition
Calories 80 cals / kg / day
High protein diet.
High iron diet for girls.
Well balanced diet CHO, milk, meat,
fat, fruits and vegetables.
Teach the child to have breakfast in the
morning.

Health promotion
Dental health
Dental hygiene. Dental checkup
Food with adequate amounts of
fluoride, vit. A & D, calcium, ascorbic
acid and phosphorus.
Minimize use of raw sugar and candies.

Health promotion
Sleep & rest
10-12 hours of sleep.

Health promotion
Activities
Physical exercises and play for 4-6 hrs.
Allow them to purchase things and
handle money.
Sex education appropriate for age and
sex.
Prevention of accidents.