THE SCHOOL-AGE CHILD
During the school-age period, the major task of the child is developing industry. The child is developing basic competency in school and in social networks and desires the approval of parents and teachers. When successful, the child has a feeling of accomplishment. During the examination, the child is cooperative and is interested in learning about the body. Language is more sophisticated now, but do not overestimate and treat the school-age child as a small adult. The child’s level of understanding does not match that of his or her speech.
Position
• The school-age child should be sitting on the examination table.
• A 5-year-old child has a sense of modesty. To maintain privacy, let the older child (an 11- or 12-year-old child) decide whether parents or siblings should be present.
Preparation
• Break the ice with small talk about family, school, friends, music, or sports
• The child should undress himself or herself, leave underpants on, and use a gown and drape
• Demonstrate equipment – a school-age child is curious to know how equipment works.
• Comment on the body and how it works. An 8- or 9-year-old child has some understanding of the body and is interested to learn more. It is rewarding to see the child’s eyes light up when he or she hears the heart sounds.
Sequence
As with the adult, progress from head to toes.