Well Child Care, 10-Year-Old

SCHOOL PERFORMANCE

Talk to your child's teacher on a regular basis to see how your child is performing in school. Remain actively involved in your child's school and school activities.

SOCIAL AND EMOTIONAL DEVELOPMENT

  • Your child may begin to identify much more closely with peers than with parents or family members.

  • Encourage social activities outside the home in play groups or sports teams. Encourage social activity during after-school programs. You may consider leaving a mature 10-year-old at home, with clear rules, for brief periods during the day.

  • Make sure you know your child's friends and their parents.

  • Teach your child to avoid others who suggest unsafe or harmful behavior.

  • Talk to your child about sex. Answer questions in clear, correct terms.

  • Teach your child how and why he or she should say "no" to tobacco, alcohol, and drugs.

  • Talk to your child about the changes of puberty. Explain how these changes occur at different times in different children.

  • Tell your child that everyone feels sad some of the time and that life is associated with ups and downs. Make sure your child knows to tell you if he or she feels sad a lot.

  • Teach your child that everyone gets angry and that talking is the best way to handle anger. Make sure your child knows to stay calm and understand the feelings of others.

  • Increased parental involvement, displays of love and caring, and explicit discussions of parental attitudes related to sex and drug abuse generally decrease risky preteen behaviors.

RECOMMENDED IMMUNIZATIONS

  • Hepatitis B vaccine. (Doses only obtained, if needed, to catch up on missed doses in the past.)

  • Tetanus and diphtheria toxoids and acellular pertussis (Tdap) vaccine. (Individuals aged 7 years and older who are not fully immunized with diphtheria and tetanus toxoids and acellular pertussis (DTaP) vaccine should receive 1 dose of Tdap as a catch-up vaccine. The Tdap dose should be obtained regardless of the length of time since the last dose of tetanus and diphtheria toxoid-containing vaccine. If additional catch-up doses are required, the remaining catch-up doses should be doses of tetanus diphtheria (Td) vaccine. The Td doses should be obtained every 10 years after the Tdap dose. Children and preteens aged 7–10 years who receive a dose of Tdap as part of the catch-up series, should not receive the recommended dose of Tdap at age 11–12 years.)

  • Haemophilus influenzae type b (Hib) vaccine. (Individuals older than 5 years of age usually do not receive the vaccine. However, any unvaccinated or partially vaccinated individuals aged 5 years or older who have certain high-risk conditions should obtain doses as recommended.)

  • Pneumococcal conjugate (PCV13) vaccine. (Preteens who have certain conditions should obtain the vaccine as recommended.)

  • Pneumococcal polysaccharide (PPSV23) vaccine. (Preteens who have certain high-risk conditions should obtain the vaccine as recommended.)

  • Inactivated poliovirus vaccine. (Doses only obtained, if needed, to catch up on missed doses in the past.)

  • Influenza vaccine. (Starting at age 6 months, all individuals should obtain influenza vaccine every year.)

  • Measles, mumps, and rubella (MMR) vaccine. (Doses should be obtained, if needed, to catch up on missed doses in the past.)

  • Varicella vaccine. (Doses should be obtained, if needed, to catch up on missed doses in the past.)

  • Hepatitis A virus vaccine. (A preteen who has not obtained the vaccine before 2 years of age should obtain the vaccine if he or she is at risk for infection or if hepatitis A protection is desired.)

  • HPV vaccine. (Preteens aged 11–12 years should obtain 3 doses. The doses can be started at age 9 years. The second dose should be obtained 1–2 months after the first dose. The third dose should be obtained 24 weeks after the first dose and 16 weeks after the second dose.)

  • Meningococcal conjugate vaccine. (Preteens who have certain high-risk conditions, are present during an outbreak, or are traveling to a country with a high rate of meningitis should obtain the vaccine.)

TESTING

Vision and hearing should be checked. Cholesterol screening is recommended for all preteens between 9 and 11 years of age. Your preteen may be screened for anemia or tuberculosis, depending upon risk factors.

NUTRITION AND ORAL HEALTH

  • Encourage low-fat milk and dairy products.

  • Limit fruit juice to 8–12 ounces (240–360 mL) each day. Avoid sugary beverages or sodas.

  • Avoid foods that are high in fat, salt, and sugar.

  • Allow your child to help with meal planning and preparation.

  • Try to make time to enjoy mealtime together as a family. Encourage conversation at mealtime.

  • Encourage healthy food choices and limit fast food.

  • Continue to monitor your child's toothbrushing and encourage regular flossing.

  • Continue fluoride supplements that are recommended because of the lack of fluoride in your water supply.

  • Schedule an annual dental exam for your child.

  • Talk to your dentist about dental sealants and whether your child may need braces.

SLEEP

Adequate sleep is still important for your child. Daily reading before bedtime helps a child to relax. Your child should avoid watching television at bedtime.

PARENTING TIPS

  • Encourage regular physical activity on a daily basis. Take walks or go on bike outings with your child.

  • Give your child chores to do around the house.

  • Be consistent and fair in discipline. Provide clear boundaries and limits with clear consequences. Be mindful to correct or discipline your child in private. Praise positive behaviors. Avoid physical punishment.

  • Teach your child to instruct bullies or others trying to hurt him or her to stop and then walk away or find an adult.

  • Ask your child if he or she feels safe at school.

  • Help your child learn to control his or her temper and get along with siblings and friends.

  • Limit television time to 2 hours each day. Children who watch too much television are more likely to become overweight. Monitor your child's choices in television. If you have cable, block channels that are not appropriate.

SAFETY

  • Provide a tobacco-free and drug-free environment for your child. Talk to your child about drug, tobacco, and alcohol use among friends or at friend's homes.

  • Monitor gang activity in your neighborhood or local schools.

  • Provide close supervision of your child's activities. Encourage having friends over but only when approved by you.

  • Children should always wear a properly fitted helmet when riding a bicycle, skating, or skateboarding. Adults should set an example and wear helmets and proper safety equipment.

  • Talk with your doctor about appropriate sports and the use of protective equipment.

  • Restrain your child in a booster seat in the back seat of the vehicle. Booster seats are needed until your child is 4 feet 9 inches (145 cm) tall and between 8 and 12 years old. Children who are old enough and large enough should use a lap-and-shoulder seat belt. The vehicle seat belts usually fit properly when your child reaches a height of 4 feet 9 inches (145 cm). This is usually between the ages of 8 and 12 years old. Never allow your child under the age of 13 to ride in the front seat with air bags.

  • Equip your home with smoke detectors and change the batteries regularly.

  • Discuss home fire escape plans with your child.

  • Teach your child not to play with matches, lighters, or candles.

  • Discourage the use of all-terrain vehicles or other motorized vehicles. Emphasize helmet use and safety and supervise your child if he or she is going to ride in them.

  • Trampolines are hazardous. If they are used, they should be surrounded by safety fences, and children using them should always be supervised by adults. Only one person should be allowed on a trampoline at a time.

  • Teach your child about the appropriate use of medications, especially if your child takes medication on a regular basis.

  • If firearms are kept in the home, guns and ammunition should be locked separately. Your child should not know the combination or where the key is kept.

  • Never allow your child to swim without adult supervision. Enroll your child in swimming lessons if your child has not learned to swim.

  • Teach your child that no adult or child should ask to see or touch his or her private parts or help with his or her private parts.

  • Teach your child that no adult should ask him or her to keep a secret or scare him or her. Teach your child to always tell you if this occurs.

  • Teach your child to ask to go home or call you to be picked up if he or she feels unsafe at a party or someone else's home.

  • Children should be protected from sun exposure. You can protect them by dressing them in clothing, hats, and other coverings. Avoid taking your child outdoors during peak sun hours. Sunburns can lead to more serious skin trouble later in life. Make sure that your child is wearing sunscreen that protects against both A and B ultraviolet rays.

  • Make sure your child knows how to call for local emergency medical help.

  • Your child should know both parent's complete names, along with cellular phone or work phone numbers.

  • Know the phone number to the poison control center in your area and keep it by the phone.

WHAT'S NEXT?

Your next visit should be when your child is 11 years old.