School-age child development describes the expected physical, emotional, and mental abilities of children ages 6 - 12 years old.

PHYSICAL DEVELOPMENT

School-age children typically have fairly smooth and strong motor skills. However, their coordination (especially eye-hand), endurance, balance, and physical tolerance vary.

Fine motor skills may also vary widely and influence a child's ability to write neatly, dress appropriately, and perform certain chores, such as making beds or doing dishes.

There will be significant differences in height, weight, and build among children of this age range. It is important to remember that genetic background, as well as nutrition and exercise, may influence a child's growth.

There can also be a big difference in the age at which children begin to develop secondary sexual characteristics. For girls, secondary sex characteristics include:

• Breast development
• Underarm and pubic hair growth

For boys, they include:

• Growth of underarm, chest, and pubic hair
• Growth of testicles and penis

LANGUAGE DEVELOPMENT

Early school-age children should be able to consistently use simple, but complete sentences that average five to seven words. As the child progresses through the elementary years, grammar and pronunciation become normal. Children use more complex sentences as they grow.

Language delays may be due to hearing or intelligence problems. In addition, children who are unable to express themselves well may be more likely to have aggressive behavior or temper tantrums.

A 6-year-old child normally can follow a series of three commands in a row. By age 10, most children can follow five commands in a row. Children with a problem in this area may try to cover it up with backtalk or clowning around. They will rarely ask for help because they are afraid of being teased.

BEHAVIOR

Frequent physical complaints (such as sore throats, tummy aches, arm or leg pain) may simply be due to a child's increased body awareness. Although there is often no physical evidence for such complaints, the complaints should be investigated to rule out possible health conditions, and to assure the child that the parent is concerned about his or her well-being.

Peer acceptance becomes increasingly important during the school-age years. Children may engage in certain behaviors to be part of "the group." Talking about these behaviors with your child will allow the child to feel accepted in the group, without crossing the boundaries of the family's behavior standards.

Friendships at this age tend to be mainly with members of the same sex. In fact, younger school-age children typically talk about members of the opposite sex as being "strange" or "awful." Children become less negative about the opposite sex as they get closer to adolescence.

Lying, cheating, and stealing are all examples of behaviors that school-age children may "try on" as they learn how to negotiate the expectations and rules placed on them by family, friends, school, and society. Parents should deal with these behaviors privately (so that the child's friends don't tease them), apply a punishment that is related to the behavior, and show forgiveness.

An ability to pay attention is important for success both at school and at home. A 6-year-old should be able to focus on an appropriate task for at least 15 minutes. By age 9, a child should be able to focus attention for about an hour.

It is important for the child to learn how to deal with failure or frustration without losing self-esteem or developing a sense of inferiority.

SAFETY

Safety is important for school-age children.

• School-age children are highly active and need strenuous physical activity, peer approval, and more daring and adventurous behaviors.
• Children should be taught to play sports in appropriate, safe, supervised areas, with proper equipment and rules. Bicycles, skateboards, in-line skates, and other types of recreational sports equipment should fit the child. They should be used only while following traffic and pedestrian rules, and while using safety equipment such as knee, elbow, wrist pads/braces, and helmets. Sports equipment should not be used in darkness or extreme weather conditions.
• Swimming and water safety lessons may help prevent drowning.
• Safety instruction regarding matches, lighters, barbecues, stoves, and open fires can prevent major burns.
• Wearing seat belts remains the most important way to prevent major injury or death from a motor vehicle accident.

• If your child's physical development appears to be outside the norm, talk to your health care provider.
• If language skills appear to be lagging, request a speech and language evaluation.
• Maintain close communication with teachers, other school personnel, and parents of friends to be aware of potential problems as they arise.
• Encourage children to express themselves openly and talk about concerns without fear of punishment.
• While encouraging children to participate in a variety of social and physical experiences, parents should be careful not to over-schedule a child's free time. Free play or simple, quiet time is important for the child not to feel constantly pushed to perform.
• Children today are exposed, through the media and their peers, to a vast array of issues dealing with violence, sexuality, and substance abuse. Discuss these issues openly with your children to share concerns or correct misconceptions. Setting limits may be necessary to ensure children will be exposed to such issues only when they are developmentally ready.
• Encourage children to participate in constructive activities such as sports, clubs, arts, music, and scouts. Staying sedentary at this age increases the risk of lifetime obesity. However, it is important not to over-schedule your child. Try to find a balance between family time, school work, free play, and structured activities.
• School-age children should participate in family chores such as setting the table and cleaning up.

Feigelman S. Middle childhood. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 11.