Health Promotion of School Age Child and Family
Health Promotion for the School-Age Child
Learning Objectives
Afterward studying this chapter, you should be able to:
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Middle childhood, ages 6 to eleven or 12 years, is probably one of the healthiest periods of life. Wearisome, steady physical growth and rapid cognitive and social development narrate this time. During these years, the child's globe expands from the tight circle of the family to include children and adults at school, at a worship customs, and in the community at large. The kid becomes increasingly independent. Peers become important every bit the child starts school and gradually moves away from the security of home. This menses is a time for best friends, sharing, and exploring.
The school years also are a time that can be stressful for a kid, and this stress can impede the child'due south successful achievement of developmental tasks. The Healthy People 2020 objectives that relate to school-age children include such goals every bit reducing obesity, improving diet, facilitating access to dental and mental health care, increasing concrete activity, and preventing loftier-risk behaviors.
Growth and Development of the School-Age Child
The school-age child develops a sense of industry (Erikson, 1963) and learns the basic skills needed to function in society. The child develops an appreciation of rules and a conscience. Cognitively, the child grows from the egocentrism of early childhood to more mature thinking. The ability to solve problems and brand independent judgments that are based on reason characterizes this new maturity. The child is invested in the task of middle childhood: learning to do things and practice them well. Competence and self-esteem increase with each bookish, social, and athletic accomplishment. The relative stability and security of the school-age menses prepare the kid to enter the emotional and concrete changes of adolescence.
Concrete Growth and Evolution
The schoolhouse-historic period years are characterized by slow and steady growth. The concrete changes that occur during this period are gradual and subtle. Although growth rates vary amid children (Figure viii-1), the average weight gain is 2.5 kg (5½ lb) per twelvemonth, and the average increase in height is approximately 5.5 cm (ii inches) per year. During the early on school-historic period menses, boys are approximately 1 inch taller and 2 lb heavier than girls. At effectually age 10 or 11 years, girls begin to catch up in size as they undergo the preadolescent growth spurt. Past age 12 years, girls are 1 inch taller than boys and two lb heavier. This growth spurt, which signals the onset of puberty, occurs
usually between ages 12 and fourteen years and occurs 2 years later in boys than in girls.
Torso Systems
Schoolhouse-historic period children appear thinner and more than svelte than preschoolers practise. Musculoskeletal growth leads to greater coordination and force. The muscles are still immature, all the same, and can exist injured from overuse. Growth of the facial bones changes facial proportions. As the facial bones grow, the eustachian tube assumes a more downward and inward position, resulting in fewer ear infections than in the preschool years. Lymphatic tissues continue to abound until about age 9 years; immunoglobulin A and G (IgA, IgG) levels reach developed values at approximately x years. Enlarged tonsils and adenoids are common during these years and are not always an indication of illness. Frontal sinuses develop at age seven years. Growth in brain size is complete by 10 years. The respiratory system too continues to mature. During the school-age years, the lungs and alveoli develop fully and fewer respiratory infections occur.
Dentition
During the school-age years, all 20 chief (deciduous) teeth are lost and are replaced by 28 of the 32 permanent teeth. All permanent teeth, except the third molars, erupt during the schoolhouse-age period. The order of eruption of permanent teeth and loss of primary teeth is shown in Figure 33-7. The first teeth to be lost are usually the lower cardinal incisors, at around age 6 years. Most first-graders are characterized by a snaggle-tooth appearance (run across Figure 8-1), and visits from the "tooth fairy" are important signs of growing up.
Sexual Development
Puberty is a time of dramatic physical change. It includes the growth spurt, development of primary and secondary sexual characteristics, and maturation of the sexual organs. The age at onset of puberty varies widely, and puberty is occurring at an before historic period than previously thought (Biro, Galvez, Greenspan, et al., 2010). Onset of puberty is no longer unusual in girls who are 8 or 9 years old. On the boilerplate, African-American girls begin puberty 1 year earlier than white girls and by age 8 years, 42.9% of African-American girls, equally compared to 18.three% of white girls, demonstrate initial signs of pubertal development (due east.g., chest budding; Biro et al., 2010). The reason for the earlier evolution amidst African-American girls is non known; however, recent inquiry suggests that information technology may exist related to food intake patterns. Puberty begins about ane½ to 2 years later in boys.
Menarche, the onset of menstruation, occurs, on average, during the 12th year, however, with the decrease in the age of puberty onset, the age at menarche is also likely to decrease.
NURSING QUALITY ALERT
Components of Sex activity Education
Females who are significantly overweight tend to have earlier onset of puberty and menarche. Because puberty is occurring increasingly before, many x- and 11-year-old girls have already had menarche. Wide variations in maturity at this age are a common cause of embarrassment because the school-historic period child does not want to appear different from peers. Children who mature either early or belatedly may struggle with feelings of self-consciousness and inferiority. Table 9-1 describes the usual sequence of appearance of secondary sex characteristics during the school-age and adolescent periods.
Because of the earlier onset of puberty, sex activity instruction programs should be introduced in elementary school. Nurses are in an excellent position to serve as resource persons for parents and teachers who are responsible for sex education. Children's questions about sexuality and related issues should exist answered honestly and in a thing-of-fact fashion. If sex activity instruction is presented within the context of learning nearly the human body, with its wonders and mysteries, children are less likely to feel embarrassed and anxious. Regardless of whether sexual practice educational activity is a part of a formal schoolhouse curriculum, children demand accurate information. Basic beefcake and physiology, information about body functions, and the expected changes of puberty should exist introduced to children earlier the onset of puberty. Older school-historic period children need data about menstruation, nocturnal emissions, and reproduction. Sex education programs must also include data virtually responsible sexuality and related issues, such equally teenage pregnancy, man immunodeficiency virus (HIV), and other sexually transmitted diseases (STDs).
Motor Evolution
Development of Gross Motor Skills
During the schoolhouse years, coordination improves. A adult sense of balance and rhythm allows children to ride a two-wheeled bicycle, dance, skip, spring rope, and participate in a variety of sports. As puberty approaches in the tardily school-age menstruum, children may go more awkward as their bodies abound faster than their ability to compensate.
Importance of Active Play
School-historic period children spend much of their time in agile play, practicing and refining motor skills. They seem to exist constantly in motion. Children of this age enjoy active sports and games, as well every bit crafts and fine motor activities (Box viii-1). Activities requiring balance and strength, such as bicycle riding, tree climbing, and skating, are exciting and fun for the schoolhouse-historic period kid. Coordination and motor skills improve as the child is given an opportunity to exercise.
Children should be encouraged to engage in physical activities. During the school-age years, children learn physical fettle skills that contribute to their health for the balance of their lives. Cardiovascular fitness, strength, and flexibility are improved by physical activity. Popular games such as tag, jump rope, and hide-and-seek provide a release of emotional tension and heighten the development of leader and follower skills.
Team sports, such as soccer and baseball, provide opportunities not just for practise and refinement of motor skills but likewise for the development of sportsmanship and teamwork. Nurses should advise parents on ways to prevent sports injuries and
how to appraise a recreational sports program (meet the Patient-Centered Teaching box: Assessing an Organized Recreational Sports Program). Sports activities should be well supervised, and protective gear (due east.thou., helmets for T-ball, shin guards for soccer) should be mandatory.
Obesity has become a major trouble in children in the Us, with 20% of children ages vi to eleven years being overweight (National Center for Health Statistics, 2011). Time spent watching tv, watching movies or playing computer games often diminishes a child's interest in active play exterior. Nurses tin assist reverse this tendency by advising parents to limit their children'southward television receiver watching time to ii hours or less per twenty-four hours and to encourage them to engage in more than agile play. Parents demand to provide adequate space for children to run, jump, and scuffle. Children should have enough free fourth dimension to practice and play. Parents need to act equally function models for both good diet and exercise.
Preventing Fatigue and Dehydration
Because children savor active play and are so total of energy, they oft do non recognize fatigue. Half dozen-twelvemonth-olds in detail volition not cease an activity to rest. Parents must learn to recognize signs of fatigue or irritability and enforce residual periods before the child becomes exhausted. Because the kid's metabolic rate is higher than an adult's and sweating ability is limited, extremes in temperature while exercising can be unsafe. Dehydration and overheating can pose threats to the child's wellness. Frequent residual periods and adequate hydration are essential for the child during concrete practise.
Development of Fine Motor Skills
Increased myelinization of the central nervous arrangement is shown past refinement of fine motor skills. Balance and mitt-eye coordination improve with maturity and practice. School-age children take pride in activities that require dexterity and fine motor skill, such as model building, playing a musical musical instrument, and drawing.
Cognitive Development
Thought processes undergo dramatic changes equally the child moves from the intuitive thinking of the preschool years to the logical thinking processes of the school-historic period years. The school-historic period child gains new knowledge and develops more efficient trouble-solving ability and greater flexibility of thinking. The 6-yr-old and the 7-year-former remain in the intuitive idea stage (Piaget, 1962) characteristic of the older preschool child. Past age 8 years, the kid moves into the stage of physical operations, followed by the stage of formal operations at around 12 years (Piaget, 1962). See Affiliate 5 for a give-and-take of formal operations and Chapter 54 for a give-and-take of the kid with cognitive deficits, including intellectual and developmental disabilities.
Intuitive Idea Stage
In the intuitive thought phase (6 to 7 years), thinking is based on immediate perceptions of the environment and the kid'due south own viewpoint (Piaget, 1962). Thinking is still characterized by egocentrism, animism, and centration (see Chapter 7). At 6 and 7 years old, children cannot understand another's viewpoint, form hypotheses, or deal with abstruse concepts. The child in the intuitive thought phase has difficulty forming categories and often solves problems by random guessing.
Physical Operations Stage
By historic period 7 or eight years, the child enters the stage of concrete operations. Children learn that their point of view is not the only i every bit they run across different interpretations of reality and begin to differentiate their own viewpoints from those of peers and adults (Piaget, 1962). This newly developed freedom from egocentrism enables children to think more flexibly and to learn about the surroundings more accurately. Problem solving becomes more efficient and reliable as the child learns how to form hypotheses. The apply of symbolism becomes more sophisticated, and children at present can dispense symbols for things in the way that they once manipulated the things themselves. The child learns the alphabet and how to read. Attention span increases as the child grows older, facilitating classroom learning.
Reversibility
Children in the physical operations stage grasp the concept of reversibility. They can mentally retrace a process, a skill necessary for understanding mathematic problems (5 + iii = 8 and 8 − 3 = 5). The child can take a toy autonomously and put it back together or walk to schoolhouse and detect the way back home without getting lost. Reversibility too enables a child to anticipate the results of actions—a valuable tool for problem solving.
The understanding of time gradually develops during the early on schoolhouse-age years. Children tin can sympathize and utilise clock time at effectually historic period 8 years. Although eight- or ix-year-old children understand calendar time and memorize dates, they practice non master historic time until subsequently.
Conservation
Gradually, the schoolhouse-age child masters the concept of conservation. The child learns that sure properties of objects practise not change simply because their order, grade, or appearance has inverse. For example, the kid who has mastered conservation of mass recognizes that a lump of clay that has been pounded apartment is all the same the same corporeality of dirt every bit when information technology was rolled into a brawl. The child understands conservation of weight when able to correctly answer the classic nonsense question, "Which weighs more than, a pound of feathers or a pound of rocks?" The concept of conservation does not develop all at once. The simpler conservations, such as number and mass, are understood first, and more complex conservations are mastered later. An understanding of conservation of weight develops at nine or ten years quondam, and an understanding of book is present at xi or 12 years.
Nomenclature and Logic
Older school-age children are able to classify objects co-ordinate to characteristics they share, to place things in a logical order, and to recall similarities and differences. This ability is reflected in the school-age child's interest in collections. Children love to collect and classify stamps, stickers, sports cards, shells, dolls, rocks, or anything imaginable. School-historic period children sympathise relationships such every bit larger and smaller, lighter and darker. They can comprehend form inclusion—the concept that objects can vest to more than one classification. For instance, a homo tin be a brother, a father, and a son at the aforementioned time.
Schoolhouse-age children move away from magical thinking every bit they discover that in that location are logical, physical explanations for nearly phenomena. The older schoolhouse-age child is a skeptic, no longer believing in Santa Claus or the Easter Bunny.
Humor
Children in the concrete operations stage have a delightful sense of sense of humour. Around age eight years, increased mastery of linguistic communication and the beginning of logic enable children to capeesh a play on words. They express mirth at incongruities and love silly jokes, riddles, and puns ("How exercise you proceed a mad elephant from charging? You lot take away its credit cards!"). Riddle and joke books make ideal gifts for young school-age children. Evidence from multiple disciplines that address the needs of children suggests that children who have a good sense of humour may use it as a positive coping machinery for stress associated with painful procedures and other situational life events.
Sensory Evolution
Vision
The eyes are fully developed by age 6 years. Visual acuity, ocular muscle control, peripheral vision, and color discrimination are fully developed by historic period 7 years. Simply before puberty, some children's eyes undergo a growth spurt, resulting in myopia. Children with poor visual vigil usually practice not complain of vision issues because the changes occur so gradually that they are difficult to detect. Usual behaviors that parents notice include squinting, moving closer to the television, or complaints of frequent headaches. The immature child may never have had 20/20 vision and has cypher with which to compare the imperfect vision. For these reasons, yearly vision screening is of import for school-age children.
Hearing
With maturation and growth of the eustachian tube, middle ear infections occur less frequently than in younger children. Nevertheless, chronic centre ear infections are a problem for a few children, when they upshot in hearing loss. Annual audiometric screening tests are important to detect hearing loss before unrecognized deficits lead to learning problems (see Chapter 55).
Language Development
Language evolution continues at a rapid pace during the school-age years. Vocabulary expands, and judgement structure becomes more circuitous. By historic period 6 years, the child's vocabulary is approximately 8000 to fourteen,000 words. There is an increase in the apply of culturally specific words at this age. Bilingual children may speak English at school and a different language at home.
Reading effectively improves language skills. Regular trips to the library, where the child tin can borrow books of special interest, can promote a dearest of reading and enhance school performance. School-age children enjoy beingness read to every bit well equally reading on their own. Older children relish horror stories, mysteries, romances, and adventure stories.
Schoolhouse-age children often go through a period in which they experiment with profanity and "dirty" jokes. Children may imitate parents who use such words as part of their vocabulary.
Psychosocial Development
Development of a Sense of Manufacture
Co-ordinate to Erikson (1963), the central job of the school-age years is the development of a sense of industry. Ideally, the child is prepared for this task with a secure sense of self as separate from loved ones in the family. The kid should have learned to trust others and should take developed a sense of autonomy and initiative during the preceding years. The school-age kid replaces fantasy play with "work" at school, crafts, chores, hobbies, and athletics. The kid is rewarded with a sense of satisfaction from achieving a skill, too equally with external rewards, such as good grades, trophies, or an assart. School-age children savour undertaking new tasks and conveying them through to completion. Whether information technology is blistering a cake, hitting a domicile run, or scoring 100 on a math test, purposeful activity leads to a sense of worth and competence. Successful resolution of the task of industry depends on learning to do things and practise them well. School-historic period children larn skills that they volition need later on to compete in the adult world. A person's fundamental attitude toward work is established during the school-age years.
Fostering Self-Esteem
The negative component of this developmental stage is a sense of inferiority (Erikson, 1963). If a child cannot separate psychologically from the parent or if expectations are prepare too high for the child to achieve, feelings of inferiority develop. If a child believes that success is unattainable, confidence is lost, and the child will not take pleasure in attempting new experiences. Children who have this feel will then accept a pervasive feeling of inferiority and incompetence that will affect all aspects of their lives. The child who lacks a sense of industry has a poor foundation for mastering the tasks of adolescence. The reality is that no i can principal everything. Every child will feel deficient or inferior at something. The task of the caring parent or teacher is to identify areas in which a kid is competent and to build on successful experiences to foster feelings of mastery and success. Nurses tin suggest means in which parents and teachers can promote a sense of self-esteem and competence in school-age children (see the Patient-Centered Teaching box: How to Promote Self-Esteem in Schoolhouse-Age Children).
At this age, the approval and esteem of those exterior the family, especially peers, get important. Children learn that their parents are not infallible. Every bit they begin to test parents' authority and noesis, the influence of teachers and other adults is felt more than and more. The peer group becomes the schoolhouse-historic period child's major socializing influence. Although parents' love, praise, and back up are needed, even craved during stressful times, the child begins to prefer activities with friends to activities with the family unit. As the kid becomes more independent, increasing time is spent with friends and abroad from the family.
The concept of friendship changes as the child matures. At 6 and 7 years old, children form friendships merely on the ground of who lives nearby or who has toys that they enjoy. Past the time children are 9 or 10 years old, friendships are based more on emotional bonds, warm feelings, and trust-building experiences. Children learn that friendship is more than simply existence together. Children at 11 and 12 years are loyal to their friends, often sharing problems and giving emotional support. Schoolhouse-age children tend to form friendships with peers of the same sex. Developing friendships and succeeding in social interactions lead to a sense of industry. Friendships are important for the emotional well-being of school-historic period children. Friends teach children skills they will utilise in future relationships.
Children learn a trunk of rules, sayings, and superstitions as they enter the civilization of babyhood. Rules are important to children considering they provide predictability and offer security. Learning the sayings, jokes, and riddles is an important part of social interaction amidst peers. Sayings such as "Step on a fissure and you'll interruption your female parent'south back" or "Finders, keepers; losers, weepers" accept been function of childhood lore for generations.
Children go sensitive to the norms and values of the peer grouping because pressure to conform is great. Children often observe that it is painful to exist different. Peer approval is a strong motivating strength and allows the child to chance disapproval from parents.
The school-historic period years are a time of formal and informal clubs. Informal clubs among vi-, seven-, and eight-year-olds are loosely organized, with fluid membership. Membership changes frequently, and it is based on mutual interests, such equally playing ball, riding bicycles, or playing with dolls. Children learn interpersonal skills, such as sharing, cooperation, and tolerance, in these groups.
Clubs amid older school-age children tend to be more than structured, oft characterized by hugger-mugger codes, rituals, and rigid rules. A club may exist formed for the purpose of exclusion, in which children snub another child for some reason.
Formal organizations, such as Male child Scouts, Daughter Scouts, Camp Fire United states of america, and 4-H, organized by adults, besides foster self-esteem and competence every bit children earn ranks and merit badges. Transmission of societal values, such every bit service to others, duty to God, and skilful citizenship, is an important goal of these organizations.
Spiritual and Moral Development
Eye babyhood years are pivotal in the development of a conscience and the internalization of values. Tremendous strides are made in moral development during these six years. Several theorists have described the dramatic growth that occurs during this stage.
Piaget
Piaget (1962) asserted that young school-age children obey rules because powerful, all-knowing adults hand them down. During this stage, children know the rules simply not the reasons backside them. Rules are interpreted in a literal fashion, and the child is unable to adjust rules to fit differing circumstances. The perception of guilt changes equally the child matures. Piaget stated that upwards to approximately age viii years, children judge degrees of guilt by the amount of damage done. No distinction is fabricated between accidental and intentional wrongdoing. For example, the child believes that a child who bankrupt five china cups past blow is guiltier than a child who broke one cup on purpose. By age 10 years, children are able to consider the intent of the action. Older school-historic period children are more than flexible in their decisions and tin can take into account extenuating circumstances.
Kohlberg
Kohlberg (1964) described moral development in terms of three levels containing six stages (run across Chapter 5). According to Kohlberg's theory, children 4 to 7 years one-time are in stage 2 of the preconventional level, in which right and incorrect are determined past physical consequences. The kid obeys because of fear of punishment. If the child is not defenseless or punished for an human activity, the child does not consider the act incorrect. At this stage, children suit to rules out of self-interest or in terms of what others tin practise in return ("I'll do this for you lot if you'll do that for me."). Beliefs is guided by an eye-for-an-eye philosophy.
Kohlberg describes children betwixt ages vii and 12 years as existence in phase iii of the conventional level. A "expert-boy" or "good-girl" orientation characterizes this phase, in which the kid conforms to rules to please others and avoid disapproval. This stage parallels the physical operations stage of cognitive evolution. Effectually age 12 years, children enter phase 4 of the conventional level. There is an orientation toward respecting authority, obeying rules, and maintaining social order. Well-nigh religions identify the age of accountability at approximately 12 years.
Family unit Influence
Children manifest antisocial behaviors during eye childhood. Behaviors such as adulterous, lying, and stealing are not uncommon. Ofttimes, children lie or cheat to get out of an embarrassing situation or to brand themselves look more of import to their peers. In nearly cases, these behaviors are small-scale; however, if they are severe or persistent, the child may need referral for counseling.
Parents and teachers greatly influence moral development. Parents tin teach children the difference between right and wrong most effectively by living according to their values. A father who lectures his kid about the importance of honesty gives a mixed message when he brags almost fooling his boss or cheating on his income tax return. The moral temper in the home is a critical factor in the child's personality development.
Children larn self-subject and internalization of values through obedience to external rules. Schoolhouse-historic period children are legalistic, and they feel loved and secure when they know that firm limits are assault their behavior. They want and expect discipline for wrongdoings. For moral teaching to exist effective, parents must be consistent in their expectations of their children and in administering rewards and punishment.
Spirituality and Religion
Spiritually, school-age children become acquainted with the bones content of their faith. Children reared inside a religious tradition experience a role of their religion. Although their thinking is all the same concrete, children begin to utilize abstract concepts to describe God and are able to cover God as a power greater than themselves or their parents. Because schoolhouse-age children remember literally, spiritual concepts accept on materialistic and concrete expression. Heaven and hell fascinate them. Concern for rules and a maturing conscience may crusade a nagging sense of guilt and fear of going to hell. Younger schoolhouse-age children still tend to acquaintance accidents and illness with punishment for real or imagined wrong-doing. Ane half-dozen-year-old child hospitalized for an appendectomy said, "God saw all the bad things I did, and He punished me." Reassurance that God does not punish children by making them sick reduces anxiety.
Wellness Promotion for the School-Historic period Child and Family
It is recommended that during eye childhood, children should visit the health care provider at least every two years. Many school districts require documentation of a routine physical exam at least once during the unproblematic school years afterwards the kindergarten visit. If children are participating in organized sports or attending army camp, an almanac physical examination might be required.
Nutrition During Middle Childhood
Nutritional Requirements
Growth continues at a tedious, regular footstep, but the schoolhouse-historic period child begins to have an increased ambition. Energy needs increase during the after schoolhouse-age years. Children in this age-group tend to take few eating idiosyncrasies and generally enjoy eating to satisfy appetite and as a social function. Children who developed dislikes for certain foods during earlier periods may continue to refuse those foods. School-historic period children are influenced by family patterns and the limitations their activities put on them. They may rush through a meal to go out to play or spotter a favorite programme on tv set.
Children need to choose a diversity of culturally advisable foods and snacks daily. Dietary recommendations for school-age children include 2½ cups of a variety of vegetables; 1½ cups of a variety of fruits; 5 ounces grains (half of which should be whole grain); 5 ounces poly peptide (lean meat, poultry, fish, beans); and iii cups of fortified nonfat milk or dairy products (U.S. Section of Agriculture, 2011). They need to limit saturated fat intake and processed sugars. Caloric and poly peptide requirements brainstorm to increase at about historic period 11 years because of the preadolescent growth spurt. The requirements for boys and girls also begin to vary at this age. A gradual increase in food intake will also accept place. The nurse should ask children to describe specifically what they consume at meals and for snacks to develop a more comprehensive moving picture of their eating habits.
When children's nutritional status is assessed, information technology is important to as well appraise any trunk prototype concerns; be sure to ask children how they feel well-nigh the way they look. Eating disorders, although thought to be a problem of adolescence, can begin in the late elementary school years.
Age-Related Nutritional Challenges
During the school years, the child's schedule changes and more fourth dimension is spent away from dwelling house. About children eat dejeuner at school, and they commonly have a choice of foods. Fifty-fifty if the parent packs a tiffin for the child to take to schoolhouse, there are no guarantees that the child volition eat the dejeuner. Unless specifically prohibited by the schoolhouse, children sometimes trade foods with other children or they may not eat a detail item. Information technology is besides during this period that the child becomes more active in clubs, sports, and other activities that interrupt the normal meal schedule.
The federal government funds the National School Lunch Program, which provides lunches free or at a reduced cost for depression-income children. The school lunch program includes approximately 1 3rd of the recommended daily dietary allowances for a child. School lunch programs unremarkably follow the dietary guidelines to run across recommended nutritional requirements; however, many school lunches are somewhat loftier in fatty. Some schools besides offer breakfast and milk programs. Many schools offering low-food, loftier-calorie snacks every bit an add-on to the schoolhouse lunch or in snack machines available in diverse locations throughout the school. In some cases, children utilize their tiffin money to buy snacks. Advise parents to communicate with their children virtually advisable lunch and snacks in school and to know what is being offered in the school cafeteria.
School-age children ordinarily request a snack after school and in the evening. Encourage parents to provide their children with healthy choices for snacks. By non ownership foods loftier in calories and low in nutrients, the parent can remove the temptation for the child to choose the less good for you foods.
Unpredictable schedules, advertising, easy admission to fast food, and peer force per unit area all take an issue on the foods a child chooses. The kid may brainstorm to adopt "junk foods," which do not accept much nutritional value. Most of these foods are high in fatty and sugar. In addition, schoolhouse-age children often skip breakfast. The family plays an of import role in modeling good eating habits for the child. Schools likewise accept a responsibleness to provide nutritious meals for children.
Dental Care
Although the incidence of dental caries (tooth decay) has declined in contempo years, tooth decay remains a significant health trouble amongst school-age children (American Academy of Pediatrics [AAP], 2008). Unfortunately, many parents and school-historic period children consider dental hygiene to exist of small importance. Many parents erroneously believe that dental care, even brushing, is non important for primary teeth because they will all autumn out anyway. Notwithstanding, premature loss of these deciduous teeth can complicate eruption of permanent teeth and lead to malocclusion.
School-age children are able to assume responsibility for their ain dental hygiene. Good oral wellness habits tend to be carried into the adult years, reducing cavity germination for a lifetime. Thorough brushing with fluoride toothpaste followed by flossing betwixt the teeth should exist done after meals and especially before bedtime. Proper brushing and flossing and a well-counterbalanced nutrition promote healthy gums and forbid cavities. Sugary or viscous between-meal snacks should be limited. Candy that dissolves quickly, such as chocolate, is less cariogenic than viscid candy, which stays in contact with teeth longer. The American Dental Association (ADA) no longer recommends routine fluoride supplementation for children who are not at risk for tooth decay (Rozier, Adair, Graham, et al., 2010).
Malocclusion
Good occlusion, or alignment, of the teeth is important for tooth formation, speech development, and physical appearance. Many school-age children need orthodontic braces to correct malocclusion, a condition in which the teeth are crowded, crooked, or out of alignment. Factors such as heredity, crevice palate, premature loss of master teeth, and mouth animate pb to malocclusion. Thumb sucking is non believed to cause malocclusion unless it persists by age v or half dozen years. However, because of business about the risk for future malocclusion, the AAP (2008) recommends that children older than iii years non continue to use a pacifier. Malocclusion becomes specially noticeable between ages 6 and 12 years, when the permanent teeth are erupting.
Children with braces are at increased run a risk for dental caries and must be scrupulous about their dental hygiene. School nurses can encourage children who clothing braces to brush after every repast and snack, eat a nutritious diet, and visit the dentist at to the lowest degree in one case every half dozen months. Utilize of a h2o option keeps gums healthy and helps remove food particles from around wires and bands.
Braces cause many children to feel self-conscious and may be hard for a school-age child to have. However, for some children, orthodontic appliances may be a condition symbol. Parental support and encouragement are important to help the child arrange to orthodontic treatment.
Preventing Dental Injuries
During the school-age years, injuries to the teeth can occur hands. Many injuries can be avoided by use of mouth protectors. These resilient shields protect against injuries by cushioning blows that might otherwise impairment teeth or lead to jaw fractures (ADA, 2011). Children should wearable a mouth protector when participating in contact sports, bicycle riding, or in-line skating. Custom-made mouth protectors synthetic past the dentist are more expensive than stock oral fissure protectors purchased in stores, but their ameliorate fit makes them more comfortable and less probable to interfere with speech and breathing. Wearing a rima oris protector is specially important for children with orthodontic braces; they protect against accidental disruption of the appliance as well as soft tissue injury that would occur from the contact betwixt the orthodontic appliance and the interior of the lips and gums (ADA, 2011).
Dental Health Education
Wellness didactics curricula demand to be designed to foster attitudes and behaviors amongst children that promote skilful personal oral hygiene practices and awareness of the risks of dental disease. The school nurse is in an fantabulous position to educate children near dental wellness and to detect bug such as untreated caries, inflamed gums, or malocclusion. The nurse should look for signs of smokeless tobacco use (irritation of the gums at the tobacco placement site, gum recession, stained teeth) and should take this opportunity to explain to the child the risks of using tobacco. The employ of snuff and chewing tobacco carries multiple dangers, including a greatly increased gamble of oral cancer and heart disease.
Sleep and Residuum
The number of hours spent sleeping decreases as the kid grows older. Children ages 6 and 7 years need about 12 hours of sleep per night. Some children also continue to need an afternoon quiet fourth dimension or nap to restore free energy levels. The 12-yr-sometime needs about nine to 10 hours of sleep at night. More sleep is needed when the child enters the preadolescent growth spurt. Adequate sleep is important for school functioning and physical growth. Inadequate sleep tin can crusade irritability, inability to concentrate, and poor schoolhouse functioning.
To promote balance and sleep, a period of quiet activity just earlier bedtime is helpful. A leisurely bedtime routine, with adequate time for the child to read, listen to the radio or MP3 histrion or just daydream, promotes relaxation. Children who do not obtain adequate rest ofttimes have difficulty getting up in the morning, creating a family disturbance every bit they rush to get ready for school, maybe skipping breakfast or leaving the firm in the estrus of frustration. A set bedtime and waking time, consistently enforced, promote security and healthful slumber habits. Bedtime offers an ideal opportunity for parent and child to share important events of the day or give a kiss and a hug, unthinkable in front of peers earlier in the day.
Source: https://nursekey.com/health-promotion-for-the-school-age-child/
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