Download SCHOOL AGE CHILDREN

SCHOOL AGE CHILDREN
GENERAL HEALTH VISITS
Preventative visits to the doctor for school age children occur less frequently than they did for
infants and toddlers. Children during this time are often seen for “sick visits” when a child
becomes ill with the flu, a cold, an ear ache or any other illness. However, there is less need for
the general health visits during this stage of life. The recommended ages for preventative visits
to the child’s pediatrician are as follows:
5 years, 1 time between the 7th and 9th birthdays, and at 12 years
During the health visits, the doctor will complete the following:
 Review and update the Health History
 Evaluate the child’s Height and Weight
 Review and update developmental history such as progression in school
 Health education and counseling
*Note: the doctor will also perform or schedule the health screenings that you will learn about
on the next screen.
Between the ages of 5-12, many new activities occur in a child’s life. They may begin school,
join an after school program or even go to camp. There may be additional health visits and
health screenings required to participate in these activities. As always, consult your pediatrician
for details.
HEALTH SCREENINGS
Below are common health screenings that the pediatrician may conduct for school age children.
Notice that they are quite similar to those infants and toddlers had.
 Health risk assessment
 Child’s development and behavior assessment and review of school performance
 Hearing and vision screens
 Blood pressure check
*Possibly lead poisoning screens (although not typically done past 5 or 6 years of age),
depending upon environmental conditions in the home
Can you identify the new health screening in this list? If not, compare the two lists when you
have completed each screen and the information is printed out for you.
IMMUNIZATIONS
If a child received their regularly scheduled immunizations as an infant and toddler, they are well
prepared to move into school and other social activities with their peers. The immunization chart
for infants and toddlers covered information up through the age of 6 years.
The only additional immunization that a school age child will need is an adult tetanus and
diphtheria (Td) shot. The Td shot should be given at the age of 12 years.
VISION CARE
At a child’s 5 year general health visit, they will receive an eye examination. The pediatrician
will check the child’s eyes and vision as well as checking the child’s eyes for proper alignment.
If the pediatrician believes there is a vision problem, the child may be referred to an eye
specialist, called an ophthalmologist.
After a child’s eye exam at their 5 year health visit, they may receive additional eye exams in
school or at their pediatrician’s office as needed. Below is a list of signs that a child may need
an eye examination:
 squinting to see the board or the teacher in school
 frequent headaches
 inability to focus
 sitting too close to the television set
 constant rubbing of their eyes
If a child requires corrective lenses (glasses), it is important to allow the child to select their own
frames. They may be sensitive about wearing their new glasses around their friends and often
need support and the opportunity to discuss their feelings. If a child wearing glasses is involved
in sport activities, consider purchasing an elastic strap for their glasses to keep them in place
during the sporting activity.
Certain diseases and health conditions can affect a child’s eye sight. One such disease is
Juvenile Diabetes. If a child has diabetes, the pediatrician will refer the child for regular vision
examinations by an ophthalmologist.
NOTE: If a child does require glasses, regardless of their age, they should have yearly check-ups
with their ophthalmologist.
AUDITORY CARE
At any time a child’s hearing may need to be tested if there is a concern that the child may be
experiencing hearing loss, especially if he or she has a history of ear infections or trouble
learning at school. Suspected hearing loss can be detected at home, by the pediatrician during a
general health visits, at school, or even by a friend or relative. Read the information below to
learn more about what types of hearing tests there are.
Behavioral tests: These tests are conducted with testers observing the child. Sounds of different
volumes, pitches, and tones are used and the child’s reaction to the noises is noted. A reaction
may be the movement of a baby’s eye, the raising of a child’s hand, or a child pointing to an
object or person.
Physiologic tests: These measures attempt to estimate a child’s ability to hear, when the child is
unable to complete the behavioral tests due to young age, disability, or other medical condition.
Auditory Brainstem Response (ABR): This diagnostic test is used with younger children or
infants. The test uses click-type noises to stimulate the nerve’s response to sound and that is then
measured to determine if hearing is within normal ranges.
The above three tests are more relevant to infants and toddlers and not typically used in schoolaged kids.
Audiometry: Hearing screening where the examiner tests hearing for a range of sounds from low
to high in each ear. The child indicates that they hear the sound by pointing to the ear where
they heard it.
Otoacoustic Emissions (OAE): This is a diagnostic test that records the echo in the ear when tiny
pulse-type sounds are given. Depending upon the type of echo, hearing may be normal or
abnormal. While this test is typically done for infants and toddlers, school age children can
receive it.
Tympanometry: This is a procedure (not a test) that measures eardrum movement in the
presence of soft sounds or air pressure. If the eardrum is not mobile (doesn’t move), it signals a
problem.
Common causes of ear problems are:
 Swimmer’s ear: painful condition caused by an infection in the outer ear canal. Bacteria
and fungi like to grow in damp, moist areas and the ear is a perfect home for them!
 Middle ear barotraumas: earache that can be caused from a child flying in an airplane. It
is due to abnormal pressure in the ear, behind the eardrum.
If a child has either of these conditions or symptoms, contact the child’s pediatrician.
Adults should be careful when cleaning the ears of a child. Do not place cotton swabs directly in
the ear canal. This may damage the ear. Use the cotton swabs for external cleaning only.
ORAL HEALTH CARE
Oral Care becomes especially important during a child’s school age years as children typically
begin to loose their primary teeth. The primary teeth, often call “baby teeth”, begin to loosen
and eventually fall out or require a dentist’s assistance to pull them out. As the baby teeth fall
out, new stronger adult teeth, called permanent teeth, replace them. It is crucial to take good care
of these permanent teeth as they come in because these are the teeth the child will have for the
rest of their life!
Children of this age must brush their teeth at least twice daily; every morning and every night.
Bacteria that sits on the teeth after eating foods begins to attack the teeth and if it is left on the
teeth overnight or all day after sleeping, the bacteria begins to create holes in the teeth, called
cavities. Gum chewing is often popular in this age group. Children should be encouraged to
chew sugarless gum.
Children at this age also must learn the importance of taking care of their gums. Healthy gums
impact general health within the body. The soft tissue in the mouth can easily become infected
and diseased. Proper flossing of the teeth once per day is needed to prevent such gum problems.
Children should limit their intake of sugary foods and visit the dentist one to two times per year.
If the child is participating in sporting activities, a mouth guard should be considered to protect
primary and permanent teeth. Lastly, some children in their age group begin to get corrective
appliances for their teeth. These corrective appliances are things like retainers or braces. These
appliances assist the child’s body in straightening teeth. Braces can be uncomfortable and often
other children tease those who do have braces. Parents and caregivers should be available to
their children to discuss any issues related to the corrective appliances.
MENTAL HEALTH
School age children are introduced to a peer group as they enter school. Children can make
terrific playmates, but they can also tease one another and be hurtful. Parents and caregivers
must pay particular attention to the emotions of school age children and talk to them everyday
about what is happening at school and with their friends. When children are supported at home
they are better equipped to deal with new pressures at school.
Building a healthy self esteem in a child is something that will benefit them throughout their life.
Reinforce and support children in the things that they do well. Offer support and encouragement
when they feel challenged or frustrated. Pay attention to significant changes in the child’s life,
such as getting glasses or new braces.
Encourage the school age child to be active and fit. Participate in family activities that promote a
healthy and active lifestyle. Children’s self esteem can be dramatically affected by a struggle
with weight.
If a child is having a problem at school, it is important to determine what the problem is.
NUTRITION
The nutritional needs of school age children are addressed in MyPyramid. Children who are 5
years old should take in approximately 1600 calories per day, while 6-12 year olds can utilize as
much as 2200 calories per day.
The key to the child’s well-balanced nutrition is providing them with choices and a variety of
foods. Have the child help pack their own school lunch, or select the food they will eat from the
hot lunch menu. Involve the child in making healthy food choices. Also, be a good role model
and stay away from fried foods, snacks that are high in sugar, and empty calorie items such as
candy, sodas, and chips. Food should NOT be used as a tool or strategy to comfort a child.
Limit snacks to 2 per day, approximately 2 hours before a meal.
School age children are at risk for obesity. With this in mind, school age children should
consume the following servings in each food group:
NOTE: Use the following as a guide only, as a person’s daily allowances in each food group
depends on age, sex, and level of physical activity per MyPyramid. To develop an
individualized plan go to the MyPyramind.gov website and click on the
5 year olds
Fruits 1 to 1 ½ cups daily
Vegetables 1 to 1 ½ cups daily
Milk 2 cups daily
Meat and Beans 2 to 4 ounce equivalents**
Grains 1 to 2 ½ ounce equivalents * daily
Oils 3 to 4 teaspoons per day
6-12 year olds
Fruits 1 to 2 cups daily
Vegetables 2 cups daily
Milk 3 cups daily
Meat and Beans 5 ounce equivalents**
Grains 3 ounce equivalents* daily
Oils 5 teaspoons per day
*In general, 1 slice of bread, 1 cup of ready-to-eat cereal, or ½ cup of cooked rice, cooked pasta,
or cooked cereal can be considered as 1 ounce equivalent from the grains group.
**In general, 1 ounce of meat, poultry or fish, ¼ cup cooked dry beans, 1 egg, 1 tablespoon of
peanut butter, or ½ ounce of nuts or seeds can be considered as 1 ounce equivalent from the meat
and beans group.
EXERCISE
As reviewed in the mental health and nutrition health components for this age group, exercise is
essential to creating a healthy body, a strong self esteem, and overall health and development.
Whether or not a child chooses to participate in an organized sporting activity, he or she can be
active and exercise to keep their bodies well.
Help the child plan active activities with their friends. Take the children to the park, a swimming
pool, or ball field. It is important to teach children lifelong activities that they can participate in
and enjoy well into their adult years. Such activities include: swimming, golf, tennis, running,
walking, gardening, and team sports. Activities can build their social skills as well. Help them
to play and meet challenges that they set for themselves, however don’t make all exercise related
to a competitive situation. Limit their TV and video game time.
By the time a child reaches 11 years old, they may be able to begin strength training activities
while under supervision. These activities help to build muscle while also strengthening the
overall body and preventing injuries.