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Bright Futures Middle Childhood 5 - 10 Years We need to do a better job of weaving a safety net of understanding, appreciation and guidance in the family, in the community and school. We need to start thinking of health and education as interlocking spheres.

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bright futures middle childhood 5 10 years

Bright FuturesMiddle Childhood5 - 10 Years

We need to do a better job of weaving a safety net of understanding, appreciation and guidance in the family, in the community and school. We need to start thinking of health and education as interlocking spheres.

-- C. Everett Koop, M.D.Former Surgeon GeneralU.S. Public Health Service

how to use bright futures developmental sections
How to Use Bright Futures:Developmental Sections
  • Each Developmental Section Includes:
    • Developmental Overview
    • Developmental Charts Family Preparation forHealth Supervision
    • Strengths and Issues of theChild, Family and Community
how to use bright futures developmental sections3
...How to Use Bright Futures:Developmental Sections
  • Health Supervision Topics
    • "Portrait" of the child and family
    • Health supervision questions
    • Developmental surveillance and milestones (or developmental surveillance and school performance)
    • Observation of parent-child interaction
    • Physical examination
    • Additional screening procedures
    • Immunizations
    • Anticipatory guidance for the family
    • Opportunities for building partnerships
middle childhood physical development
Middle Childhood:Physical Development
  • Physical Development
  • Cognitive Development
  • Social/Emotional Development
  • Moral/Spiritual Development
  • Health Behaviors
middle childhood cognitive development
…Middle Childhood:Cognitive Development
  • Physical Development
  • Cognitive Development
  • Social/Emotional Development
  • Moral/Spiritual Development
  • Health Behaviors
middle childhood social emotional development
…Middle Childhood:Social/Emotional Development
  • Physical Development
  • Cognitive Development
  • Social/Emotional Development
  • Moral/Spiritual Development
  • Health Behaviors
middle childhood moral spiritual development
…Middle Childhood:Moral/Spiritual Development
  • Physical Development
  • Cognitive/Linguistic Development
  • Social/Emotional Development
  • Moral/SpiritualDevelopment
  • Health Behaviors
middle childhood health behavior
…Middle Childhood:Health Behavior
  • Physical Development
  • Cognitive/Linguistic Development
  • Social/Emotional/Behavioral Development
  • Children withSpecial Health Care Needs
  • Health Behavior
family preparation for middle childhood health supervision
Family Preparation for MiddleChildhood Health Supervision
  • Be prepared to give updates on the following at your next visits…
  • Be prepared to provide the following information about your family…
  • Prepare and bring in questions, concerns about…
  • Other
family preparation provide family information
...Family PreparationProvide Family Information
  • Be prepared to give updates on the following at your next visits…
  • Be prepared to provide the following information about your family…
  • Prepare and bring in questions, concerns about…
  • Other
family preparation bring questions concerns
...Family PreparationBring Questions, Concerns
  • Be prepared to give updates on the following at your next visits…
  • Be prepared to provide the following information about your family…
  • Prepare and bring in questions, concerns about…
  • Other
family preparation other information
...Family PreparationOther Information
  • Be prepared to give updates on the following at your next visits…
  • Be prepared to provide the following information about your family…
  • Prepare and bring in questions, concerns about…
  • Other
strengths child
Strengths: Child
  • Child
    • Has good physical health and nutrition
    • Has good eating habits Is developing a sense of responsibility for personal health
    • Has regular oral health care
    • Engages in physical activities Has positive attitude
    • Feels loved and valued by parents and other adults
    • Has one or more close friends Is developing social competence
  • Expresses feelings
  • Enjoys life and has joyful experiences
  • Participates in social activities
  • Has personal sense of competence
  • Has high self-esteem and expects personal success
  • Has opportunities for new challenges
  • Feels comfortable asking questions of parents and teachers
  • Works hard in school
  • Has positive role models
strengths family
...Strengths: Family
  • Family
    • Meets child's basic needs (food, shelter, clothing, safety, health care)
    • Provides strong, nurturing family
    • Provides safe environment (e.g., smoke alarms, car booster seat or safety belt)
    • Enjoys child
    • Responds to child's developmental needs
    • Encourages good communication
    • Spends individual time with child
    • Praises and takes pride in child's achievements
  • Affirms child's feeling of being loved
  • Helps child develop social competence
  • Possesses working knowledge of child health and development
  • Serves nutritious family meals regularly
  • Reinforces health as a family priority
  • Allows age-appropriate autonomy
  • Protects child against excessive stress
  • Provides value system, good parental role models
  • Promotes cooperation among siblings
  • Has support of extended family and others
  • Encourages participation in community
strengths community
...Strengths: Community
  • Community
    • Provides quality schools and educational opportunities for all families
    • Provides supervised programs for children (recreational, sports, educational, social, cultural)
    • Provides activities for families
    • Promotes physical activity (e.g., safe playgrounds, parks)
    • Encourages participation of children in organized groups
    • Provides support for families with special needs (school meal programs, educational programs)
  • Provides outreach to identify uninsured or underinsured children & facilitates enrollment in health insurance programs &access to care
  • Provides neighborhood/school settings with supervised before- and after-school activities
  • Provides an environment free of hazards
  • Ensures safe neighborhoods
  • Provides affordable housing and public transportation
  • Develops integrated systems of health care
  • Fluoridates drinking water
issues child
Issues: Child
  • Child
    • School concerns (learning disabilities, underachievement, difficulty completing homework, frequent school absence or tardiness/school avoidance)
    • Behavioral concerns (hyperactivity, inability to concentrate, temper outbursts, lying, aggression, fighting, stealing, vandalism, cruelty, violence)
    • Peer concerns (inability to get along with other children, lack of friends, excessive shyness)
  • Emotional concerns (separation problems, depression, anxiety, low self-esteem, threat of suicide)
  • Risk-taking behavior (sexual activity, use of alcohol, drugs, or tobacco)
  • Weight and height concerns (short stature, obesity, eating disorders)
  • Physical inactivity
  • Chronic illness
  • Physical complaints
  • Tics
  • Developmental delays
issues family
...Issues: Family
  • Family
    • Parents or other family members with serious problems (depressed, mentally ill, abusive, overly critical, overprotective, incarcerated)
    • Severe marital problems
    • Domestic violence (verbal, physical, emotional, or sexual abuse)
    • Frequently absent parent
    • Rotating "parents" (parents' male or female partners)
    • Inadequate child care arrangements
    • Family health problems
  • Substance use (alcohol, drugs, tobacco)
  • Financial insecurity
  • Homelessness
  • Family transitions (moves, births, divorce, remarriage, incarceration, death)
  • Lack of knowledge about child development
  • Lack of parenting skills, parental self-esteem, or self-efficacy
  • Intrusive family members
  • Social isolation and lack of support
  • Neglect or rejection of child
issues community
...Issues: Community
  • Community
    • Poverty
    • Inadequate housing
    • Environmental hazards
    • Unsafe neighborhood
    • Discrimination and prejudice
    • Community violence, gangs
    • Few opportunities for employment
    • Inadequate or unsafe schools
    • Lack of supervised programs before and after school
    • Lack of programs for families with special needs
  • Inadequate outreach to uninsured and underinsured children and failure to facilitate enrollment in health insurance programs and access to care
  • Lack of social support
  • Isolation in a rural community
  • Lack of social, educational, cultural, and recreational opportunities
  • Lack of access to immunizations and to medical and oral health services
  • Inadequate public services (lighting, transportation, garbage removal)
  • Inadequate fluoride in drinking water
health supervision five year visit questions for parent s
Health Supervision: Five Year Visit - Questions for Parent(s)
  • Questions for the Parent(s)
  • Questions for the Child
  • Developmental Surveillance and Milestones
  • Observation of Parent-Child Interaction
  • Physical Examination
  • Additional Screening Procedures and Immunizations
  • Anticipatory Guidance For the Family
    • Promotion of Healthy and Safe Habits
    • Promotion of Social Competence
    • Promotion of Constructive Family Relationships & Parental Health
    • Promotion of Community Interactions
    • Promotion of Successful School Entry
five year visit questions for child
...Five Year Visit:Questions for Child
  • Questions for the Parent(s)
  • Questions for the Child
  • Developmental Surveillance and Milestones
  • Observation of Parent-Child Interaction
  • Physical Examination
  • Additional Screening Procedures and Immunizations
  • Anticipatory Guidance For the Family
    • Promotion of Healthy and Safe Habits
    • Promotion of Social Competence
    • Promotion of Constructive Family Relationships & Parental Health
    • Promotion of Community Interactions
    • Promotion of Successful School Entry
five year visit developmental surveillance
...Five Year Visit:Developmental Surveillance
  • Questions for the Parent(s)
  • Questions for the Child
  • Developmental Surveillance and Milestones
  • Observation of Parent-Child Interaction
  • Physical Examination
  • Additional Screening Procedures and Immunizations
  • Anticipatory Guidance For the Family
    • Promotion of Healthy and Safe Habits
    • Promotion of Social Competence
    • Promotion of Constructive Family Relationships & Parental Health
    • Promotion of Community Interactions
    • Promotion of Successful School Entry
five year visit observation
…Five Year Visit:Observation
  • Questions for the Parent(s)
  • Questions for the Child
  • Developmental Surveillance and Milestones
  • Observation of Parent-Child Interaction
  • Physical Examination
  • Additional Screening Procedures and Immunizations
  • Anticipatory Guidance For the Family
    • Promotion of Healthy and Safe Habits
    • Promotion of Social Competence
    • Promotion of Constructive Family Relationships & Parental Health
    • Promotion of Community Interactions
    • Promotion of Successful School Entry
five year visit physical examination
...Five Year Visit:Physical Examination
  • Questions for the Parent(s)
  • Questions for the Child
  • Developmental Surveillance and Milestones
  • Observation of Parent-Child Interaction
  • Physical Examination
  • Additional Screening Procedures and Immunizations
  • Anticipatory Guidance For the Family
    • Promotion of Healthy and Safe Habits
    • Promotion of Social Competence
    • Promotion of Constructive Family Relationships & Parental Health
    • Promotion of Community Interactions
    • Promotion of Successful School Entry
five year visit additional screenings
...Five Year Visit:Additional Screenings
  • Questions for the Parent(s)
  • Questions for the Child
  • Developmental Surveillance and Milestones
  • Observation of Parent-Child Interaction
  • Physical Examination
  • Additional Screening Procedures and Immunizations
  • Anticipatory Guidance For the Family
    • Promotion of Healthy and Safe Habits
    • Promotion of Social Competence
    • Promotion of Constructive Family Relationships & Parental Health
    • Promotion of Community Interactions
    • Promotion of Successful School Entry
five year visit anticipatory guidance
...Five Year Visit:Anticipatory Guidance
  • Questions for the Parent(s)
  • Questions for the Child
  • Developmental Surveillance and Milestones
  • Observation of Parent-Child Interaction
  • Physical Examination
  • Additional Screening Procedures and Immunizations
  • Anticipatory Guidance For the Family
    • Promotion of Healthy and Safe Habits
    • Promotion of Social Competence
    • Promotion of Constructive Family Relationships & Parental Health
    • Promotion of Community Interactions
    • Promotion of Successful School Entry
middle childhood 5 10 years
Middle Childhood: 5 - 10 Years
  • Summary of Health Supervision Visits
    • Five Year Visit
    • Six Year Visit
    • Eight Year Visit
    • Ten Year Visit
building partnerships during middle childhood
Building Partnerships During Middle Childhood

What Else Should We Talk About ?

  • Summarize findings at theend of each visit.
  • Arrange Continuing Care
    • Before the Next Visit
    • Other Care
    • Strengths
building partnerships
...Building Partnerships

What Else Should We Talk About ?

  • Summarize findings at the end of each visit.
  • Arrange Continuing Care
    • Before the Next Visit
    • Other Care
periodicity schedule
Periodicity Schedule

For the 29 Recommended Health Supervision Visits

bright futures pocket guide
Bright FuturesPocket Guide

New design to come

to order additional materials and to find out more about bright futures contact
To order additional materials and to find out more about Bright Futures, contact:

Bright Futures Project

National Center for Education in

Maternal and Child Health

Georgetown University

2000 15th Street, North, Suite 701

Arlington, VA 22201-2617

Tel: (703) 524-7802

Fax: (703) 524-9335

E-mail: BrightFutures@ncemch.org

Bright Futures Web site: www.brightfutures.org