The School-Aged and Adolescent Child

Introduction to Development and Interpersonal Violence

Understanding the health and developmental needs of school-aged and adolescent children is essential for promoting lifelong well-being. This section covers the physical, psychosocial, and cognitive changes during these stages, as well as the impact of interpersonal violence.

• Development: Refers to the sequence of physical, psychosocial, and cognitive changes across the human lifespan.

• Interpersonal Violence: Intentional use of physical force or power against another person, including physical, psychological, sexual violence, neglect, and deprivation.

Growth and Development in School-Aged Children (6-12 years)

Psychosocial and Cognitive Development

School-aged children experience significant growth and development, influenced by various psychosocial theories.

• Erikson: Industry vs. Inferiority – children strive for competence and success.

• Kohlberg: Preconventional level – moral reasoning based on consequences.

• Piaget: Concrete operations (7-11 years) – logical thinking about concrete events.

• Maturation: Rates vary between boys and girls; notable changes in oral development, lymph tissue growth, and motor skills.

Views of Parents and Adults

• Ages 6-8: Family-oriented, seek parental approval, gradually gain independence.

• Ages 9-12: Begin to question parental authority, feel smarter than adults.

Health Promotion Needs & Risk Factors

School-aged children face various health risks and require targeted health promotion strategies.

• Physical activities and leisure

• Poverty

• Nutrition and dental health

• Safety

• Fostering positive self-concept

• Chronic diseases

• Prevention/treatment of abuse

• Aggression/bullying

• Healthy choices regarding substance use

Physical and Leisure Activities

Motor Skill Development

Physical activity is crucial for developing strength, balance, and coordination in school-aged children.

• Major changes in motor skills between ages 6-12

• Skills refined: running, jumping, balancing, throwing, catching

• Health promotion: Encourage regular physical activity

Health Promotion Efforts

• Assess appropriateness of activities based on maturity

• Provide information about programs and facilities

• Select activities for social, psychomotor, emotional, and cognitive development

Poverty and Its Impact on Health

Child and Family Poverty in Canada

Poverty is a significant threat to health and quality of life, affecting physical, mental, emotional, economic, and social well-being.

• Over 1 million children living in poverty in Canada (2021)

• Higher rates among marginalized groups: Indigenous, racialized, immigrant, lone-parent families, and those with disabilities

Poverty Reduction Strategies

• Government initiatives to improve well-being

• Nurses must be aware of resources to assist families in poverty

Nutrition and Dental Health

Nutrition

Proper nutrition is essential for growth and development. Nurses must be familiar with national food guidelines and address food insecurity.

• Calcium is important for bone development and density

• Promote positive mealtimes and healthy relationships with food

• Support school lunch programs

Dental Health

Loss of baby teeth and emergence of adult teeth are key milestones. Dental hygiene and regular check-ups are vital.

• Children over 6 years can start supervised tooth brushing with fluoride toothpaste

• Check-ups every 6 months; nutrition is a major factor in dental health

Safety

Types of Safety Concerns

Accidents are the leading cause of death in school-aged children. Safety education is crucial.

• Play, sports, school, street, and internet safety

• Bicycle/skateboard safety

• Sports injury prevention and concussion awareness

• Motor vehicle, playground, fire, water, and internet safety

Health Promotion Efforts

• Teach safety directly or act as a resource

• Balance caution with normal development

Child Abuse and Interpersonal Violence

Types of Abuse

Child abuse includes physical, sexual, emotional abuse, neglect, and exposure to family violence. Early intervention is critical.

• Self-reported childhood physical and/or sexual abuse: 20.19% (Stats Canada, 2020)

• Trauma and violence-informed approaches are recommended

Fostering Positive Self-Concept and Emotional Development

Self-Concept

Self-concept develops over time and is influenced by self-esteem, sense of control, body concept, and sex roles.

• Promote positive parental feedback

• Allow choices to reinforce internal locus of control

• Open discussions on sexuality and sex education

Aggression, Bullying, and Healthy Choices

Aggression and Bullying

Intentional injury and aggression in early life can lead to emotional problems later. Anti-bullying programs and conflict management are essential.

• Consistent love and affection

• Supervision and appropriate behavior modeling

• No access to weapons

Substance Use

Substance use occurs in this age group; education and prevention programs are vital.

• Smoking, vaping, and drugs negatively affect health

• Focus on making non-smoking and drug-free life the norm

Immunization and Health Promotion

Immunization Schedule

Immunizations are essential for preventing infectious diseases in school-aged children.

• Ages 4-6: DTaP-IPV or Tdap-IPV

• Grade 4: Men-C-ACYW-135

• Grade 6: HB, HPV-9

• COVID and Influenza vaccines recommended

Adolescent Health Promotion and Protection

Developmental Tasks and Issues

Adolescence involves psychosocial, emotional, cognitive, and moral transitions. Key issues include self-esteem, unhealthy choices, sexuality, safety, mental health, and physical activity.

• Freud: Genital stage

• Erikson: Identity vs. Role Confusion

• Piaget: Formal operations (age 11+)

Self-Esteem and Body Image

Self-esteem is formed early but fluctuates during adolescence. Influences include family, peers, teachers, and media.

• Rapid physical and sexual maturation can cause stress

• External vs. internal locus of control affects self-esteem

• Poor body image and low self-esteem impact mental health

Sexuality

Sexuality is a central aspect of adolescence. Positive sexual attitudes and reliable information are necessary to prevent risky behaviors and support identity development.

• Strong societal messages influence early intimate relationships

• Health promotion: Affirming care, parental involvement, education projects

Oral Health and Health Screening

Oral Health

Adolescents with orthodontics require specialized care. Dental caries and gingivitis are common problems.

• Regular hygiene and check-ups are important

• Signs: broken, dark teeth, bleeding, inflamed gums

Health Screening

• Female: Breast self-awareness, HPV vaccine

• Male: Testicular self-exam, HPV vaccine

• All: Eye exams, cholesterol, substance abuse, depression, eating disorders

Physical Activity

Promotion and Barriers

Many adolescents are not active enough for optimal growth. Nurses should advocate for increased activity and collaborate with schools.

• Moderate activities: biking, walking, soccer, weight training

• Balance physical activity, sedentary behavior, and sleep

Alcohol, Tobacco, and Drug Use

Substance Use Trends

Substance use is a major concern among adolescents. Education, prevention, and community strategies are essential.

• Alcohol, cannabis, hallucinogens, and prescription drugs are commonly used

• Reasons: curiosity, peer pressure, insecurity, need for acceptance, easy availability

• Prevention: family focus, school policies, peer support, community buy-in

Safety Issues and Injury Prevention

Types of Injuries

Injuries are the leading cause of death among youth. Risk-taking behaviors, substance use, and inadequate physical activity contribute to morbidity and mortality.

• Motor vehicle accidents, sports injuries, homicide, suicide

• Prevention: driver education, community safety, water safety, supportive environments

Abuse, Neglect, and Maltreatment

Nurse's Role

Nurses must screen for abuse, establish trust, and communicate effectively. Abuse may present with similar signs as in younger children.

• Careful screening and strong communication skills

• Interview alone when appropriate

Mental Health and Internet Safety

Mental Health Concerns

Emotional and behavioral issues are common in adolescence. Suicide is the second leading cause of death.

• 1 in 5 teenagers have emotional problems

• 1 in 10 have serious disturbances

• Teachers often unprepared to assess suicide risk

Internet and Social Media Safety

The internet is a valuable tool but poses risks such as inappropriate material, cyberbullying, sextortion, and human trafficking. Open communication and monitoring are essential.

• Discuss risks and public nature of online activity

• Encourage reporting concerns to parents or responsible adults

Societal Trends and Health Promotion Strategies

Factors Influencing Adolescent Issues

• Family structure changes, technology, exposure to sexual content, decreased face-to-face interaction

• Health promotion: Accepting environment, gradual increase in responsibilities, structure and limits

Immunization Schedule for Adolescents

• Grades 8 & 9: Tdap (Tetanus/diphtheria/acellular Pertussis)

• COVID and Influenza vaccines recommended

Additional info: Academic context and expanded explanations were added to ensure completeness and clarity for exam preparation.