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The Preschool Years, Middle Childhood, Adolescent (Pediatrics) - Coggle…

- - - - Visual acuity 20/30
      - primary teeth erupted
      - Handedness established
    - - Visual acuity 20/20
      - Bed-wetting in girls
    - - Bed-wetting in boys
    - - Toe walking should not persist
      - throwing, catching and kicking
        balls, riding on bicycles; climbing on playground structures,dancing
  - - - Vocabulary increases from 50-100 words to more than 2,000
      - Rule of thumb
      - Do not use figurative speech
    - - can count to 4 & use the
        past tense
    - - use the future tense
  - - - TV and similar media limited to 2Hr/ day
  - - - more than 15 min or regularly occurring more than 3
        times/day
        
        reflect underlying medical
    - - mimic the corporal punishment
        
        more aggressive behaviors
      - Discipline
        
        “countdown"
- - - - Myelinization
        
        peak gray matter at 12-14 yr.
    - - Loss of deciduous
        
        6 yr of age
      - Replacement with adult teeth - 4 per year
      - Premolars erupt by 11-12 yr of age
    - - Prepubertal children should not engage in high-stress, high impact sports
  - - - begin to thinking about concrete events
      - understand the concept of conservation
      - thinking becomes more logical and organized
      - using inductive logic, or reasoning from specific
      - understand the
        content
    - - Pediatricians preparation: for school entrance
      - Promote 5Rs
        
        reading
        
        rhyming
        
        routines and regular times for meals
        
        reward
        
        reciprocal nurturing relationships
  - - - school
      - neighbor
      - Home
    - - Remove TV limit viewing to
        2Hr/ day
- - - - Middle Adolescence
        
        14-17 years
      - Late Adolescence
        
        18-21 years
      - Early Adolescence
        
        11-14 years
  - - - Personal
      - Sexual
      - Vocational
      - Moral
  - - - Pituitary gland secreted LH and FSH
      - hormone leptin (increased body fat and earlier onset of puberty)
    - - Weight gain
      - Adult body composition
      - Growth spurt
      - Secondary sexual
        
        breasts, pubic hair, genital development
      - Menstrual periods and sexual maturity
  - - - Stage of Males
        
        3
        
        PUBIC HAIR
        
        Darker, starting to curl, small amount
        
        PENIS
        
        Lengthens
        
        TESTES
        
        Larger
        
        4
        
        PUBIC HAIR
        
        Resembles adult type, but less
        quantity; coarse, curly
        
        PENIS
        
        Larger; glans and breadth
        increase in size
        
        TESTES
        
        Larger, scrotum dark
        
        2
        
        PUBIC HAIR
        
        Scant, long, slightly pigmented
        
        PENIS
        
        Minimal change/enlargement
        
        TESTES
        
        Enlarged scrotum, pink,texture altered
        
        5
        
        PUBIC HAIR
        
        Adult distribution, spread to medial surface of thighs
        
        PENIS
        
        Adult size
        
        TESTES
        
        Adult size
        
        1
        
        PENIS
        
        Preadolescent
        
        TESTES
        
        Preadolescent
        
        PUBIC HAIR
        
        None
      - Stage of females
        
        3
        
        PUBIC HAIR
        
        Darker, beginning to curl, increased amount
        
        BREASTS
        
        Breast and areola enlarged, no contour separation
        
        4
        
        PUBIC HAIR
        
        Coarse, curly, abundant, but less than in
        adult
        
        BREASTS
        
        Areola and papilla form secondary mound
        
        2
        
        PUBIC HAIR
        
        Sparse, lightly pigmented, straight, medial border of labia
        
        BREASTS
        
        Breast and papilla elevated as small mound; diameter of areola increased
        
        5
        
        PUBIC HAIR
        
        Adult feminine triangle, spread to medial
        surface of thighs
        
        BREASTS
        
        Mature, nipple projects, areola part of general breast
        contour
        
        1
        
        BREASTS
        
        Preadolescent
        
        PUBIC HAIR
        
        Preadolescent
  - - - Cognitive and Moral
        
        Emergence of abstract thought, Strong emotions
      - Physical
        
        Females
        
        peak growth velocity,
        menarche (if not already attained)
        
        Males
        
        growth spurt, secondary sex characteristics, nocturnal
        emissions, facial and body hair,voice changes
        Change in body composition
        Acne
      - Family
        
        Conflicts over control and
        independence
        Struggle for greater autonomy
        Increased separation from parents
      - Sexual maturity rating
        
        3-5
      - range
        
        14-17 yr
      - Self-concept/identity
        formation
        
        Concern with attractiveness
        Increasing introspection
      - Peers
        
        Intense peer group involvement
        Preoccupation with peer culture
        Conformity
      - Sexual
        
        Initiation of relationships and
        sexual activity
        Exploration of sexual identity
    - - Cognitive and Moral
        
        Idealism,things through
        independently
      - Self-concept/identity
        formation
        
        Attractiveness
        Consolidation
        of identity
      - Physical
        
        Physical
        maturation slows
        Increased lean muscle mass in males
      - Family
        
        Emotional and physical
        separation from family Increased
        autonomy
        Reestablishment of “adult”
        relationship with parents
      - Sexual maturity rating
        
        5
      - Peers
        
        Peer group and values recede in importance
      - range
        
        18-21 yr
      - Sexual
        
        Consolidation
        of sexual
        Planning for future and
        commitment
    - - Cognitive and Moral
        
        Concrete operations
        Egocentricity
        Unable to perceive long-term outcome of current decisions Follow rules to avoid punishment
      - Self-concept/identity
        formation
        
        Preoccupied with changing
        body
        Self-consciousness about appearance and
        attractiveness
      - Physical
        
        Females
        
        secondary sex characteristics (breast,pubic, axillary hair), start of growth spurt.
        
        Males
        
        testicular enlargement, start of genital growth
      - Family
        
        Increased need for privacy
        Exploration of boundaries of dependence vs independence
      - Sexual maturity rating
        
        1-2
      - Peers
        
        Same-sex peer affiliations
      - range
        
        10-13 yr
      - Sexual
        
        Increased interest in sexual
        anatomy
        Anxieties and questions
        about pubertal changes
        Limited capacity for
        intimacy