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c. Height ranges from 45 inches (115 cm) at age 6 years to
                                                59 inches (150 cm) at age 12 years.
                                             d. School-age children gain weight at a rate of about 4.5
                                                to 6.5 pounds (2 to 3 kg) per year.
                                             e. Average weight is 46 pounds (21 kg) at age 6 years
                                                and 88 pounds (40 kg) at age 12 years.
                                             f. The first permanent (secondary) teeth erupt around
                                                age 6 years, and deciduous teeth are lost gradually.

                                             g.        Regular dentist visits are necessary, and the

                                                school-age child needs to be
                                             h. Supervised with brushing and flossing teeth; fluoride
                                                supplements may be necessary if the water is not
                                                fluoridated.
                                             i. For school-age children with primary and permanent
                                                dentition, the best toothbrush is one with soft nylon
                                                bristles and an overall length of about 6 inches (15
                                                cm).
                                             j. Sleep requirements range from 10 to 12 hours a night.
                                2. Vital signs (Box 18-11)
                                3. Nutrition
                                             a. School-age children will have increased growth needs
                                                as they approach adolescence.
                                             b. Children require a balanced diet from foods in the
                                                MyPlate food guide; healthy snacks should continue
                                                to be emphasized to prevent childhood obesity (see
                                                www.choosemyplate.gov).
                                             c. Children still may be picky eaters but are usually
                                                willing to try new foods.
                                4. Skills
                                             a. School-age children exhibit refinement of fine motor
                                                skills.
                                             b. Development of gross motor skills continues.
                                             c. Strength and endurance increase.
                                5. Play
                                             a. Play is more competitive.
                                             b. Rules and rituals are important aspects of play and
                                                games.

                                             c.        The school-age child enjoys drawing, collecting

                                                items, dolls, pets, guessing games, board games,
                                                listening to the radio, TV, reading, watching videos or
                                                DVDs, and computer games.
                                             d. The child participates in team sports.
                                             e. The child may participate in secret clubs, group peer
                                                activities, and scout organizations.
                                6. Safety




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