During this time period, children grow about 2 inches each year. Development is not as rapid. Appetites vary with growth. At this age, children become increasingly independent and more involved with friends. They are busy with school projects, book reports, and collecting objects that interest them. Many children will have collections of rocks, coins, sports memorabilia, etc. It is important to ask about school performance, including attendance during their visits. Is he able to keep up in school? Do he pay attention in class? School performance is a great indicator of their development. Also, think about self-esteem. Ask about what he does well and what he enjoys. Ask him if he is happy. By 9-10 years of age children are savvier about technology. It is important to discuss internet safety, parental supervision, filters, and media time.

Bright Futures Discussion Topics

The first priority is to listen to the concerns of the parents. Always observe the parent-child interaction during the entire visit. Reinforce positive interactions and discuss any concerns. If there are siblings in the room, how do they interact with the child? Is the parent positive about the child?

Bright Futures gives priority to these topics during the 7 – 10 year visit.

Social determinants of health

• Assess risks: neighborhood and family violence, food security, family substance use, and harm from the internet.
• Assess strengths and protective factors: emotional security, self-esteem, and connectedness with family and peers.

Development and mental health

• Independence
• Rules and consequences
• Temper Problems
• Conflict Resolution
• Puberty and pubertal development

School

• Adaptation to school, behavior, or learning issues
• School attendance and performance
• Special education services
• Involvement in school activities and after school programs

Physical growth and development

• Oral health: regular visits with the dentist, daily brushing and flossing, adequate fluoride, avoidance of sugar-sweetened beverages and snacks
• Nutrition: healthy weight, adequate calcium, and vitamin D intake
• Physical activity: 60 minutes of physical activity a day, screen time

Safety

• Car safety
• Safety during physical activity
• Water safety
• Sun protection
• Harm from adults
• Firearm safety

Commonly Seen during this Age Group

• Eruptions or permanent teeth are in the same order as the primary teeth are lost.
• Tonsillar tissue is beginning to enlarge, reaching its peak from 8 to 12 years.
• Orthopedic
  • Fractures, sprains, strains
  • Epiphyseal separations, dislocations
  • Scoliosis
  • Avascular necrosing lesions of epiphysis.
  • Legg-Calve-Perthes disease
  • Osgood-Schlatter disease