Well Child Care, 6 Years Old

PHYSICAL DEVELOPMENT

A 6-year-old can skip with alternating feet, can jump over obstacles, can balance on 1 foot for at least 10 seconds and can ride a bicycle.

SOCIAL AND EMOTIONAL DEVELOPMENT

  • Your child should enjoy playing with friends and wants to be like others, but still seeks the approval of his parents. A 6-year-old can follow rules and play competitive games, including board games, card games, and can play on organized sports teams. Children are very physically active at this age. Talk to your caregiver if you think your child is hyperactive, has an abnormally short attention span, or is very forgetful.

  • Encourage social activities outside the home in play groups or sports teams. After school programs encourage social activity. Do not leave children unsupervised in the home after school.

  • Sexual curiosity is common. Answer questions in clear terms, using correct terms.

MENTAL DEVELOPMENT

The 6-year-old can copy a diamond and draw a person with at least 14 different features. They can print their first and last names. They know the alphabet. They are able to retell a story in great detail.

IMMUNIZATIONS

By school entry, children should be up to date on their immunizations, but the caregiver may recommend catch-up immunizations if any were missed. Make sure your child has received at least 2 doses of MMR (measles, mumps, and rubella) and 2 doses of varicella or "chickenpox." Note that these may have been given as a combined MMR-V (measles, mumps, rubella, and varicella. Annual influenza or "flu" vaccination should be considered during flu season.

TESTING

Hearing and vision should be tested. The child may be screened for anemia, lead poisoning, tuberculosis, and high cholesterol, depending upon risk factors. You should discuss the needs and reasons with your caregiver.

NUTRITION AND ORAL HEALTH

  • Encourage low fat milk and dairy products.

  • Limit fruit juice to 4 to 6 ounces per day of a vitamin C containing juice.

  • Avoid high fat, high salt, and high sugar choices.

  • Allow children to help with meal planning and preparation. Six-year-olds like to help out in the kitchen.

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

  • Model good nutritional choices and limit fast food choices.

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

  • Continue fluoride supplements if recommended due to inadequate fluoride in your water supply.

  • Schedule a regular dental examination for your child.

ELIMINATION

Nighttime wetting may still be normal, especially for boys or for those with a family history of bedwetting. Talk to the child's caregiver if this is concerning.

SLEEP

  • Adequate sleep is still important for your child. Daily reading before bedtime helps the child to relax. Continue bedtime routines. Avoid television watching at bedtime.

  • Sleep disturbances may be related to family stress and should be discussed with the health care provider if they become frequent.

PARENTING TIPS

  • Try to balance the child's need for independence and the enforcement of social rules.

  • Recognize the child's desire for privacy.

  • Maintain close contact with the child's teacher and school. Ask your child about school.

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

  • The child should be given some chores to do around the house.

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

  • Limit television time to 1 to 2 hours per day! Children who watch excessive television are more likely to become overweight. Monitor children's choices in television. If you have cable, block those channels which are not acceptable for viewing by young children.

SAFETY

  • Provide a tobacco-free and drug-free environment for your child.

  • Children should always wear a properly fitted helmet on your child when they are riding a bicycle. Adults should model wearing of helmets and proper bicycle safety.

  • Always enclose pools in fences with self-latching gates. Enroll your child in swimming lessons.

  • Restrain your child in a booster seat in the back seat of the vehicle. Never place a 6-year-old child in the front seat with air bags.

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

  • Discuss fire escape plans with your child should a fire happen. Teach your children not to play with matches, lighters, and candles.

  • Avoid purchasing motorized vehicles for your children.

  • Keep medications and poisons capped and out of reach of children.

  • If firearms are kept in the home, both guns and ammunition should be locked separately.

  • Be careful with hot liquids and sharp or heavy objects in the kitchen.

  • Street and water safety should be discussed with your children. Use close adult supervision at all times when a child is playing near a street or body of water. Never allow the child to swim without adult supervision.

  • Discuss avoiding contact with strangers or accepting gifts or candies from strangers. Encourage the child to tell you if someone touches them in an inappropriate way or place.

  • Warn your child about walking up to unfamiliar animals, especially when the animals are eating.

  • Make sure that your child is wearing sunscreen which protects against UV-A and UV-B and is at least sun protection factor of 15 (SPF-15) or higher when out in the sun to minimize early sun burning. This can lead to more serious skin trouble later in life.

  • Make sure your child knows how to call your local emergency services (911 in U.S.) in case of an emergency.

  • Teach children their names, addresses, and phone numbers.

  • Make sure the child knows the parents' complete names and cell phone or work phone numbers.

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

WHAT'S NEXT?

The next visit should be when the child is 7 years old.