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Quick reference medical handouts used by Pediatric offices


Growth Milestones - 10 Years


"The Pre-Adolescent"

This age has been called the beginning of pre-adolescence. Children begin to "spread out" as their rate of development accelerates. Some begin to grow rapidly and mature early. In every fifth grade room there will be one or two girls who are already menstruating. By the age of 10, children have informally chosen the leader of their peer group, whether it is the child who plays baseball well, the one who can run fast or the one with new ideas for games. At the same time, those who fail to fit in are often reminded of their faults and pushed aside. 10 year olds have primarily same-sex friends. Friends assume greater importance, and the child's independence from the family is now obvious.

This may be a relatively calm period for your child. Pre-adolescents are fairly easy to get along with. They are affectionate with both Mom and Dad. But, at the end of this age, you may begin to notice a change in mood. Get ready! You are about to enter adolescence.

Parenting and Behavioral
  • The 10-year-old is very social. Even though family is important, your child will value his or her friends and their opinions very highly. Supporting and enhancing your child's self-esteem and self-confidence is critical during this period. Children who feel good about themselves are better equipped to withstand negative peer pressure. Parents need to spend time with their child, talk to him or her, and praise him or her for achievements made. Identify your child's strengths and always keep the lines of communication open.
  • A possible conflict arises for parents when they misinterpret the child's alignment with peers. Parents can acknowledge their child's desire for independence by offering increasing responsibility. For example, parents may identify certain tasks as appropriate chores, while allowing the child to decide himself when to complete them. An allowance may also promote your child's growing sense of independence.
  • No one likes to be different. If your 10-year-old is small and skinny and or does not come up to the shoulder of some of his or her classmates, reassure your child that there is nothing wrong and he or she soon will begin to grow.
  • Children this age are usually industrious, helping with household tasks, pet responsibilities and small domestic projects.
  • The 10-year-old enjoys being together. They play board games and cards or watch TV. Your child may want to join a club in your neighborhood or at school. He or she may enjoy an organized group such as scouts or a religious group. As a parent, you should support these kinds of activities in your child's community.
  • School is very important in the life of a 10-year-old and school progress, achievements or problems can become a major issue. Learning problems may not become evident until the later elementary school years, as classroom expectations for performance increase. Some children are apprehensive about the transition into middle school. It is therefore important that parents monitor their child's school progress and keep in touch with teachers and school administrators.
 
Development
  • Able to tell time.
  • Can read for pleasure.
  • Has a sense of humor ("do you know any good jokes? What's your favorite joke?").
  • Is concerned about rules - good (fair) vs. bad (unfair).
  • Cares for himself/herself, his/her room and his/her belongings; can take responsibility for home chores.
  • Has more control over small muscles, and therefore writes and draws with more skill.
  • Likes to belong to informal "clubs" formed by children.
Oral Health
  • Ensure that your child brushes his or her teeth twice a day with a pea-size amount of fluoridated toothpaste and flosses.
  • Give your child fluoride supplements as recommended by the health professional based on the level of fluoride in your drinking water.
  • Schedule a dental appointment for the child every six months, unless his dentist determines otherwise based on his individual needs/susceptibility to disease.
  • As your child's permanent molars erupt, ensure that the dentist evaluates them for application of dental sealants.
  • Reinforce with your child how to handle dental emergencies, especially the loss or fracture of a tooth.
  • Reinforce with your child the dangers of smoking and smokeless tobacco.
Nutrition
  • Poor appetite is rarely a problem in this age period. In fact, the reverse is true, especially in girls. Encourage your child to eat three regular meals per day and nutritious snacks.
  • It is especially important during this age period to evaluate your child's food consumption, along with the amount of exercise he or she is doing. Obesity is worrisome in this age. Studies have shown that children who weigh too much at this time are more likely to be overweight as adults.
  • Share meals as a family on a regular basis. Make mealtimes pleasant and companionable. Encourage conversation.
  • Model and encourage good eating habits. Serve a variety of healthy foods.
  • Teach your child how to choose nutritious snacks rich in complex carbohydrates. Limit high-fat or low-nutrient foods and beverages such as candy, chips or soft drinks.
  • Teach your child how to eat a balanced diet. Teach him or her to choose plenty of fruits and vegetables; breads, cereals and other grain products; low-fat dairy products; lean meats; and foods prepared with little or no fat.
  • Teach your child how to eat a nutritious lunch at school, either through the school lunch program or by packing a balanced lunch.
  • Children watch what their parents eat, so set a good example.
Sleep
  • Sleep problems are rare at this age, except for an occasional nightmare. With homework, TV and extra activities, many children are sleep-deficit. Children this age need nine to 10 hours of sleep per night.
Immunizations
Since immunization schedules vary from doctor to doctor, and new vaccines may have been introduced,it is always best to seek the advice of your child's health care provider concerning your child's vaccine schedule.
  • Most children have received the following vaccines and no immunizations are usually given at this age:
5 doses of DTaP vaccine
4 doses of HIB vaccine
2 doses of the Chickenpox vaccine
4 doses of the penumococcal vaccine (If born after 1999)
3 doses of Hepatitis B vaccine
2 doses of the MMR vaccine
4 dose of the Inactivated Polio Vaccine
3 doses of Rotavirus Vaccine
  • Annual flu vaccines for children with chronic illnesses like asthma and heart defects. Check with your doctor.
  • Vision and hearing, as well as blood and urine, are usually checked at this visit. Other screening done at this age may include a tuberculin test (if indicated) and blood pressure. If there is a family history of elevated cholesterol, some physicians will also obtain a screening blood test.
  • The physician and his or her staff, as well as the parents, should respect the child's privacy by using appropriate draping during the 10-year examination.
Sexuality
  • Do not wait until your child is mature to let him or her in on some of the changes taking place in their classmates. You are wrong if you think a 10-year-old is still too young to talk about such things. An open dialogue with your child about puberty and sex can help ensure he or she learns facts within a framework of values that your family feels is important. If this is uncomfortable for you, ask the child's doctor for help and/or references.
  • If the child receives family life education at school or in the community, discuss it with him or her. Provide additional information as needed.
  • For parents of girls: Prepare your daughter for menstruation.
  • For parents of boys: Prepare your son for wet dreams.
  • Begin to teach the child that delaying sexual behavior is the surest form of protection against disease and pregnancy.
  • Explore the child's understanding of sexually transmitted diseases, including AIDS.
Safety

Injury prevention should be stressed with the 10-year-old. Preadolescents may engage in dangerous risk-taking behaviors (e.g., dares, drinking, smoking) as a result of peer pressure. Some children are able to influence their peers to engage in dangerous or illegal activities against their better judgment. If the peer group includes older children, the child may encounter pressure to perform acts and take risks for which he or she is not developmentally competent. Recognizing this possibility may help parents teach their children about dealing with negative peer pressure.

  • Continue to teach your child that all firearms are unsafe and should be presumed loaded. Store all weapons unloaded in locked cabinets. Ammunition should be similarly locked but in a different location. Most firearm injuries occur in and about the home. Ask friends if they have a gun in the home. Teach your children the NEW rules of gun safety: Never touch a gun; Every Gun is Loaded; When in doubt, get out. Exploring, experimenting and curiosity lead to accidents and injuries from firearms, falls, automobile accidents and drowning. Anticipate that your child may make errors in judgment because he or she is trying to imitate peers. Educate and reinforce the principles of safety especially since the 10-year-old is usually under less adult supervision.
  • Anticipate that your child may make errors in judgment due to increased risk-taking behavior.
  • Anticipate providing less direct supervision.
  • Continue to ensure that your child wears a seat belt in the car at all times.
  • Reinforce with your child the safety rules for swimming pools. Teach your child how to swim.
  • Ensure that your child puts on sunscreen before he or she goes outside for long periods of time.
  • Continue to keep your child's environment free of smoke.
  • Test smoke detectors to ensure they work properly. Change batteries yearly.
  • Reinforce with your child the safety rules for the home, including what to do when home alone. Discuss visitors, not tying up the telephone for long periods of time and what to do in case of fire or other emergencies. Conduct fire drills at home.
  • Reinforce safety rules for bicycles. Ensure that your child always wears a helmet when riding a bicycle.
  • Reinforce sports safety with your child, including the need to wear protective sports gear such as a mouth guard or a face protector.
  • Teach your child to avoid high noise levels, especially when using music headsets.
Health Promotion
  • Supervise your child's activities with peers.
  • Be a role model for your child by having a healthy lifestyle.
  • Ensure that your child gets adequate sleep.
  • Encourage regular physical activity.
  • Enforce reasonable television/music standards.
  • Supervise your child's personal care and hygiene.
  • Counsel your child about avoiding the use of alcohol, tobacco and drugs.
  • Ensure that your child's school curriculum includes information about substance abuse.
Check your child's progress with our Growth Charts.
The information presented in Growth Milestones was obtained with the help of our pediatric experts and with material from The American Academy of Pediatrics' Guidelines for Health Supervision and Bright Futures' Guidelines for Health Supervision of Infants, Children, and Adolescents. Bright Futures is supported by the Maternal and Child Health Bureau, U.S. Department of Health and Human Services.. Updated 05-08-07

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As a reminder, this information should not be relied on as medical advice and is not intended to replace the advice of your child’s pediatrician. Please read our full disclaimer.

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