Seven To Ten Year Visit

A child’s seventh through tenth years mark the transition from childhood to pre-adolescence (yes it starts very young these days).  It’s a time of exploration, learning, and increasing independence.  Relationships at school and with friends take on an increasingly important role, but strong parental guidance and interaction are still needed.  Don’t miss the opportunities to spend time with your child through these delightful years.

The average growth rate during this time is two inches per year and 2-5 pounds per year.  Children at this age are often too busy to be bothered with eating well.  Resist the trend towards substituting high fat, low nutritional snacks and “fast” food for good meals.  This doesn’t mean forcing them to eat three huge meals a day.  Let their appetites regulate the quantity while you regulate the quality of what is being consumed.   We will be measuring your child’s body mass index (BMI) and we will be discussing healthy lifestyle issues with your child at each visit.

The AAP recommends vitamin D supplementation for all infants, children, and adolescents.  After reviewing the literature, it certainly looks like many children may benefit from vitamin D, although not everyone necessarily needs it.   Some children are more at risk for vitamin D deficiency than others.  Risk factors for vitamin D deficiency include dark skin (African-americans, Indians, Hispanics), time spent indoors and not out in the sunlight (particularly in the winter months), low amount of milk consumption (less than 16 oz a day), and obesity.  The recommended dose is 400 IU (international units) once daily.  This can be bought over the counter in either liquid, chewable, or pill form.  Another option would be a multivitamin (i.e. Flintstones Gummies Complete ).   Read the label carefully when dosing this to your child.  Too much vitamin D can be harmful.

During these years the influence of peer relationships increases dramatically.  There is a strong “herd instinct” and you will notice that children of this age will want to do everything exactly as their friends do.  This is especially true of appearance and clothes.  Be flexible and allow them some freedom of expression while trying to encourage some individual thinking and responsible behavior (nobody said it was easy being a parent).

It’s important to allow your child some independence so they will learn decision-making skills.  Don’t always bail them out when they make bad choices-they need to learn to deal with the consequences of wrong decisions.  On the other hand, there will be times you need to step in and give clear, firm direction.  Issues of safety and health are good examples.  Children of this age group don’t often consider long term results and even think of themselves as indestructible.  Therefore, you will have to insist on the wearing of the seatbelt, helmet, and safety gear for rollerblading; brushing and flossing teeth, use of sunscreen etc.  Also remember that it is the law that children must be in a booster seat until they are 4 foot 9 inches tall!

If there are guns or firearms in the home, be sure to unload them, use trigger locks, and store weapons securely in a locked cabinet separate from ammunition.  Also lock keys to the firearms, trigger locks, and ammunition cabinet in a separate location and keep that key with you at all times.  Be sure to inquire if firearms are present and stored safely in friend’s and neighbor’s home where your child may play.

In spite of what movies may suggest, children at this age are not yet ready to be left home alone.

Make time to spend together as a family.  Frequent family meals, reading together, playing games, vacations, and special celebrations are ways of demonstrating your child’s importance to you and will establish home, not just friends, is a place to go with problems and questions.  Encourage plenty of physical activity, 60 minutes each day is the target, and discourage unattended TV viewing which can expose your  child to negative influences at an impressionable age.  Watch TV and movies with your child and listen to their music so you can discuss the values and ideas being presented.  One hour of screen time (TV, video, computer) is the recommendation as these activities take away time from other important activities.

Spend time listening to your child.  Be ready to talk about anything.  It’s time to discuss puberty and sexuality, drug abuse, smoking, school problems, how to choose friends, and what to do with the neighborhood bully.  If they sense your willingness to talk about these issues now, your child is more likely to seek your counsel in the years to come.

This is a common time for school problems.  These may include attention disorders, learning disabilities, behavior problems, and emotional difficulties.  These can occur in combination.  Proper treatment requires the united efforts of parents, child, school (including teachers, psychologists, educational specialists, and various therapists) and the pediatrician.  If you believe that your child is having school problems, please let us know so that we can schedule a conference with you.  Due to the complex nature of these problems, the amount of information gathering needed and the number of people involved in treatment, it will require a number of visits and a significant amount of time for proper care.

IMMUNIZATIONS

No routine immunizations are given at this age unless something has been missed in the previous years.  We do recommend a yearly flu shot though.