EPSDT Care for Kids Newsletter

Winter 2010

Anticipatory Guidance for 5-10 Year Olds

by Stacy McConkey, MD, Department of Pediatrics
University of Iowa Children’s Hospital

Well Child visits in the middle of childhood take on a different focus than those for younger children. Children are undergoing slower physical development in terms of growth and fine and gross motor skills, with most of the development going on in the cognitive and social skills areas. Bright Futures anticipatory guidance changes its focus to different areas as well. It may be helpful to consider some of the developmental tasks of this age group prior to going through the anticipatory guidance itself. The following is a summary of some of the developmental tasks by age.


THE PRIMARY TASK FOR:
5 year olds is school readiness. How easily will the child separate from his or her parents? Are they capable of following directions, getting along with others, and do they have impulse control? What is their span of attention? These are questions that need to be addressed during the pre-kindergarten visit. 6 year olds would like to be more independent from parents and other supervisory adults, but are not always capable of making good decisions about safety. They also are developing the cognitive skills that allow them to participate in health-care related discussions. During this visit it is important to include them directly in the discussion to encourage these communication skills.		7 year olds are starting to develop their conscience, which assists in understanding rules and relationships, as well as the development of morals and coping skills. They are busy comparing their family’s values and morals to those around them, particularly to those of their best friends, which is a new milestone for them as well. 8 year olds are developing skills in multitasking and logic, which changes how they approach school and socializing tasks.
9 and 10 year olds are possibly starting to undergo pubertal development (10 years old for girls and 11 years old for boys). They continue to desire independence from their parents, which can create some difficult situations for families. At this age it is very important for families to support their child’s self-confidence and self-esteem to enable a child to withstand peer pressure.