School age 6-12 development, red flag, AG

molunowa's version from 2016-01-05 18:24

Section 1

Question Answer
identify self-identity and sex roleschool aged
work toward independence from familyschool aged
acquire school learning basics, reading writing and mathschool aged
increased muscle strength6-9y
running, jumping, climbing, hopping, skipping, tandem walking and alternate foot patterns6-9 y
overhand throwing are perfected6-9y
learn how to swim6-9y
learn how to ride bike6-9y
particpate in team sports6-9y
prints then writes in cursive, draws6-9y
uses simple instruments6-9y
detailed pictures6-9y
hand-eye coordination6-9y
able to play musical instrument6-9y
able to share and cooperate6-9y
understand meaning of social situations and interpret social cues of others6-9y
enjoys games and group play6-9y
beings to enjoy competition6-9y
interested in peers, especially opposite sex6-9y
language very descriptive6-9y
tells stories6-9y
mastery of articulation6-7y
tells jokes8y
less mechanical reading, more fluid enjoyable reading6-9y
awkwardness and unsure of self is more the rule than the exception10-12y
peer group becomes source of support, guidance, self-esteem10-12y
may have a best friend10-12y
good relationship with parents10-12y
transition to abstract thinking10-12y
more interested in reading and other intellectual skills10-12y
beginning to think logically10-12y

Section 2

Question Answer
poor school adjustment6-9y
using aggressive behavior to get attention6-9y
accident prone or frequent illness6-9y
problems with peer groups6-9y
difficulty learning and attending6-9y
unable to state specialy quality about self, flat affect, depression, withdrawl6-9y
regressive patterns of overdependence on family, shyness, passivity or aggression10-12y
using food to get attention or satisfaction10-12y
using illness as a means to avoid challenges10-12y
using food to get attention or satisfaction10-12y
inability to make and sustain friendships10-12y
antisocial behavior and not using language to express ideas and feelings10-12y
poor school performance10-12y
risk taking behaviors sex, drug10-12y
flat affect, depression, withdrawl10-12y
defiant, rebellious attitude10-12y

Section 3

Question Answer
3 meals 2 snacks a day80 k/cal/day early school age DECREASES to 50k/cal/day by age 10
low fat milk16-20 oz daily, 800-1200mg of calcium day
portion sizehalf of an adults
physical activity60 minutes a day
baby teeth to permenant teethschool aged
sex and sexualityincreased in this age group open communication
begin std talkschool aged
late school agedmenstruation begins for most girls
sleep8-14 hours, decreased with OSA, obesity, GERD and asthma
seek influence of people outside of familyteachers, peers, sports
peersmore and more important and parents less important
lyingbecomes a problem. reinforce honest behavior, reassure that in real world absolute truths do not exist
screen time1-2 hours a day, watch for violence, no tv in bedroom
disciplineconsistency is most important, give some control over decision making, limitations made clear, logical discipline withdraw privileges
choresexpectations early, increase with age
self esteemestablished by strong relationships with peers and family and success in activities
less positive self esteemgirls late school aged, encourage through positive reinforcement and positive female role models
MVA crashesleading cause of death school aged, pedestrian, drowning, fires and falls
booster seastsschool aged, 4-8 yrs of age or above 80lbs and 4'9
backseatuntil 13 years of age!
weight4-6 lbs per year, jumps to 90% of adult weight by age 10-11
BMIweight in kg / height in m2
overweightBMI 85% agove
obeseBMI 90% agove
height2-3 inches year, over 1/2 girls 10-11 will be adult height
peak height velocity girls11.5 - 12 years most growth BEFORE menarche, after very rare for girls to gain more height
visual acuity20/20 by age 7
>90 dBProfound hearing loss
loose deciduous teeth and get permanent onesage 6-7, loose teeth in same order which the primary teeth erupted
permenant teethage 12
tonsils normalize in size by age6-8y
functional murmurs still present in 50% of kids, SINUS arrythmia most common
PMI5th ICS by age 8
breast development 9-13yrs; 11 average
girls OVER 7become thoracic breathers, boys remain diaphragmatic breathers
pectus excavatumdepressed sternum respiratory or cardiac problems
delayed pubertyno secondary sex characteristics at 13 for girls and 14 for boys
testicle development9-10 years
penile growthone year after testicular growth
pubic hair boysage 12
girls pubic hair8-12 years, vaginal secretions increase and hips broader
ossifybones begin to ossify at this age
Legge Calve Perthesknee pain and or limp pain at this age
brain grwothslows at age 7; middle school reaches 90% of adult size
full adult sizeattained at age 12
eye hand coordination perfecedage 12
dominance of left or right sidednesses emergesschool aged
fasting lipid panel9-11 years universal lipid screening

Section 4

Question Answer
lyingschool age children work on differentiating fantasies from reality; manage: point out fantasy and reality, renforce honest behavior, real word absolute truth dont exsist
school phobia/refusalform of seperation anxiety where child has variety somatic complaints and problems sleeping; child feels better as day progresses; manage: support parents, send to school full time, no improvement 2 weeks REFER TO PSYCH
learning problemsmain task of school aged child to learn reading, writing and math requires: basic info processing, memorization, increased attention span, recall importat events, start of problem solving skills
mental retardation2-3%
learning disability7-10%
emotional disturbance10-15%
chronic illness5%
auditory processing disorderinability to hold sequence of sounds or words in their minds
visual spacial deficitpercieve objects, space, letters or words on a piece of paper difficult
motor planning deficitdifficulty planning sequential beahvior such as drawing, tying a shoe, playing the drums, writing math
anemiaconsider in learning deficitis
bullyingintentionally malicious, done to provoke, denigrate or humilate another child. mean spirited emotional or physical behavior intended to instill fear and demoralize through abuse
risk factors make children more vulnerable bullyingshy demeanor, lack close friends, overprotective parents or family crisis, racial, physical disabilities
male bullyingverbalize threats, 6-8 times more likely to hit back when hit, agression r/t: poor school performance, problem drinking and l/t unemployment
female bullyingmost socially skilled in the group, mature and worldly, seductive aura, manipulative, sweet loving appearnce with hidden agenda
relational aggresiongirls: harms others through damage or threat of relationships; group inclusion
indirect aggresiongirls: covert behavior - using others as a vehicle to inflict pain and acting innocent
social aggressiondamage self esteem or social status within group
recommend to parents of victims of bullyingshare feelings, brainstorm action plan, ASSERTIVENESS TEACHING, role playing as bully
recommend to parents of bulliesaggressive behavior often learned at home, limit violent media exposure, elminate physical punishment, build their sense of empathy, praise good behavior
scoliosis3-5% of school aged kids, right thoracic single curve most common; 75% are idopathic
childhood scoliosiseffects boys and girls equally in childhood
idiopathic scoliosisafter age 10: 6:1 more common in GIRLs
functional scoliosisno fixed deformity of the spine so apparent curvature disappears when lying down or flexing forward. Cause = poor posture, leg length discrepnscies, muscle spasm, injury, herniated disc
structural scoliosisspines curves laterally which forces vertebrae to rotate cause rib HUMP
other causes of scoliosiscongenital, idopathic, neuromuscular. fractures/dislocations, tumors, metabolic disorders = osteogensesis imperfecta, marfan syndrome
pain present with scoliosisbone tumors, spondoloysis assymmetry of shoulder
curve 20-25 degreesmonitor
curve 25-45 degreesrefer, brace in growing children not adults
milwaukee bracegoal not to correct exsisting curve but PREVENT further curvature
harrington rod or posterior spinal fusionreserved for curves 45 degrees plus
x-ray with Cobb anglesordered specailly in females noted to have scoliosis on exam prior to growth spurt
growing pains15-30% of all kids, frequent ages 3-6 years normal part of growth and development
growing painsoccur at night, front of thighs, calves and behind the knees, NEVER JOINTS; may waken child from sleep
growing painsshort in duration, bilateral and resolve within minutes
No limp or inflammationmust consider leukemia! bone tumors, fibromyalgia
tx growing painsheat, analgesia and massage, stretching. refer if pain severe or persistent
continence day2.5 years 50%; 4 years 90%
coninence night3 years 66%; 4 years 90%
increased UOdiabetes both kinds, sickle cell anemia, large water intake
bladder irritabilityUTI, bladder spasms, constipation
abnormal sphincter controlspinal cord abnormalities, detrusor instability, sphincter weakness
structural problemectopic ureter, vaginal reflux, epispadious
hormonal regulartionlow levels of antidiuretic hormone contribute to enuresis
PE eneuresisNeuro exam with DTRs and perianal sensation, examine girl/boy urethra
urgency containment exerciseshold urine as long as possible, stop and start stream
eneuresis alarms90% effective when used with DDAVP (desmopressin)
GI complaint causespeptic ulcer, peritonitis, infections, pancreatitis, parasitic infections, UTI, renal stones, hematolgic and vascular disorders = sickle cell disease and rheumatic fever, diabetes, appe, meckels diverticulum
stop nose bleedsit upright and slightly forward, direct pressure on anterior midportion of nose for 5-10 mintues
cotton pledgetsmoisten with few drosp of vasocnstrictur 0.25% Neo-Synephrine or Epi 1:100 and apply additonal pressure 10 mintues
first degree burnsuperficial, involve only epidermis. Erythemia, slightly edema, tender/pain
second degree burnepidermis and varying degree of dermis. Red, swollen, MOIST, blistering, sensitive to air
third degree burninvolves epidermis, dermis and ermal appendages, WHITE/BLACK, swollen, NO PAIN
when to refer burns3rd degree, 2nd degree over large parts of body, 1st degree not responding to tx
sun tan lotionspf of at least 15 (35-45 PREFERRED) every 2-3 hrs, reapply sweat swim
latchkey children2-5 million kids under age 13 go home to an empty house, greater risk for obesity, look for alternative in community and affordable after school programs
2-4 years divorceregressive behavior
3-5 years divorceaggressive behavior
5-6 years divorcewhiny, immature behavior
6-adolescent divorcedisequilibrium, depression, somatic c/o, poor school
divorce referprolonged behavior, depression, child rejects peers and normal acitivies, holds it all in
divorce guidancetold by both parents; before parent leaves (weeks ahead-older; days ahead younger), calmy at home, stress child not to blame and between parents explain expected schedule