What to Expect as Your Child Grows:
Well Child Care at 10 Years

Nutrition

• Many children and adults eat too many calories from high-fat foods, sweets, and large portion sizes. Set a good example.
• Eat meals as a family when possible. Encourage everyone to eat slowly and enjoy the conversation as well as the food.
• Involve your children with meal planning and writing grocery lists. This helps them learn, and they can make their own decisions about new foods to try.
• Keep healthy snacks on hand.

Development

• Many girls and few boys have a growth spurt at this age. The start of sexual development is normally soon followed by this growth spurt. Girls usually start their sexual development one or two years earlier than boys.
• School achievement is very important for ten-year-olds. Reading, writing, and arithmetic should be the focus of learning. Make sure your child takes responsibility for bringing home schoolwork and has a good place to study at home.
• Help your child get involved in school or extracurricular activities. Sports should be fun and focus on sportsmanship, rather than winning and losing. Make sure your child gets plenty of physical activity everyday.
• Ten-year-olds particularly like doing chores. They enjoy hearing from parents that they have done a chore well. It is important for children to begin to think of themselves as capable of accomplishing things. Ask your healthcare provider if you child doesn't believe he can do chores or other tasks. This may be an appropriate age to introduce allowance.
• Projecting a positive self-esteem is very important at this age. Children should not always be putting themselves down. Ask your healthcare provider for advice if your child consistently has a poor self-esteem. Kids want to dress the way their friends' dress. This is important for your children and, within reason, you should respect your children's choices. Similarly, your children will want to speak with words that may be unique to their peers, age group, or pop culture. Again, within reason, this choice is to be respected.

Behavior and Discipline

• Ten-year-olds have an increasing ability to function without adult supervision at school, on the playground, at home, and in safe community locations. They have learned most social rules and understand the need for rules. Discuss with your children how they can begin to be responsible for their behaviors.
• Parents play an important role in the life of a ten-year-old. The parent of the same gender as the child plays a particularly important role at this time. Despite the attention given to popular culture heroes, role-modeling by parents is very important.
• Ten-year-olds should be responsible for their actions and expect responsible behavior from their friends and peers. The opinions of friends are very important, perhaps more important than their parents' opinions. Discuss with your child how to make good choices in the company of friends.
• Parents and kids should discuss issues of sexuality. When kids realize that parents feel comfortable with discussing sex, they ask for information more often. Their issues and questions start to come up naturally. Take advantage of these times to discuss values and answer any question honestly.

Media

• Reading is very important for ten-year-olds. Be sure to read at every opportunity with your child and discuss the book. Let your child read and tell you stories from books.
• Encourage your child to participate in family games and other activities. Limit "screen time." Carefully select the programs you allow your child to view. Be sure to watch and discuss some of the programs with your child. Do not put a television in your child's bedroom.
• Your child should not be exposed to shows or games with violent or sexual themes. The ratings systems for movies, games, and television are good guides for what is appropriate for your child.

Safety Tips

• Accidents are the number one cause of death in children. Kids like to take risks at this age but are not well prepared to judge the degree of those risks. Therefore, ten-year-olds still need supervision. Parents should model safe choices.
• Car Safety
  - Everyone in a car should always wear seat belts.
• Pedestrian Safety
  - Children at this age will generally cross streets safely. However, be sure that you practice this skill when your child has a new street to cross.
  - Make sure your child always uses a bicycle helmet. You can set a good example by always wearing a helmet.
  - Your child is not ready for riding on busy streets. Begin to teach your child about riding a bicycle where cars are not present.
  - Don't buy a bicycle that is too big for your child.
• Strangers
  - Discuss safety outside the home with your child.
  - Make sure your child knows his address, phone number, and his parents' places of work.
  - Remind your child never to go anywhere with a stranger.

Smoking

• Children who live in a house where someone smokes have more respiratory infections. Their symptoms are also more severe and last longer than those of children who live in a smoke-free home.
• If you smoke, set a quit date and stop. Set a good example for your child. If you cannot quit, do NOT smoke in the house or near children.
• Teach your children that even though smoking is unhealthy, they should be civil and polite when they are around people who smoke.

Immunizations

• Your child should already be current on all routinely recommended vaccinations. Additional vaccines are sometimes given when children travel outside the country. Ask your doctor if you have any questions about immunizations.
• Annual flu vaccines are recommended.

Next Visit

The American Academy of Pediatrics recommends that your child have a routine check-up every year.

What to Expect as Your Child Grows:
Well Child Care at 11-12 Years

Nutrition

• Nutrition is very important for children at this age. They are growing rapidly and require lots of calories.
• The best way to get your children to eat well is to be a role model and to get them involved in meal planning. Adolescents tend to have too much fat, cholesterol, salt, and sugar in their diets. Purchase plenty of fruits, vegetables, and calcium-rich foods. Iron-rich foods (especially meats, nuts, soy, and iron-enriched cereals) are important, especially for menstruating girls. Children often gain too much weight from overeating high-calorie snacks and fast foods, drinking too much soda and juice, and not getting enough exercise. Your healthcare provider should check your child's weight at least once per year.
• Ask your children for their thoughts on the best way to prepare foods, how they perceive their body, and the amount of activity they need for good health. Have open-ended conversations about the habits that lead to gaining too much weight such as not exercising enough, skipping meals, drinking too many soft drinks, and eating a lot of fast food. If your pre-teens are eating when not hungry or bored, encourage them to do something else, such as exercising, reading, or working on a project to stop thinking about food.

Development

• Most girls and some boys are well into rapid physical growth of adolescence. Ask your healthcare provider if you have specific questions about your children's physical and emotional changes as they mature.
• School achievement is very important at this age. Pre-teens should take responsibility for completing their homework and achieving goals. Each child has different skills and limitations. Stay involved with your child's schoolwork, and be a cheerleader, rewarding efforts and achievements with praise.
• Pre-teens have many questions about sex and they need the facts. They need to learn about menstrual periods, erections, wet dreams, sexual intercourse, and relationships. It's important for parents to talk to their daughters about menstrual periods and their sons about wet dreams so they'll know these events are normal. If you are not comfortable talking with your child, ask your healthcare provider for help.
• It is also important to teach your child that sex should involve human feelings, such as commitment, belonging, self-esteem, and love. Pre-teens need your advice.

Behavior and Discipline

• Parents play an important role in the life of a pre-teen. Despite the attention given to popular culture heroes, role-modeling by parents is very important. Involvement by adults of both genders is best.
• At this age, peer pressure can be hard to resist. Watch for signs of changes in your child's normal behaviors that go against the family's value system. To prevent problems, try to get to know your child's friends and their parents. Children who are most successful at resisting negative peer pressure are those with a strong self concept who have the confidence to say "No." Discuss with your pre-teen how to make good choices in the company of friends. Use your praise and attention when your children do the right thing. Catch them being good.

Media

• Pre-teens can get bored with simple characters or predictable stories. They are capable of more complex thought and are able to put themselves in another's place. They can appreciate books that highlight different points of view. Reading can inspire courage, compassion, and commitment. Talk with your child at every opportunity about the books your children are reading, and what they think about what they have read.
• Encourage your child to participate in family games and outdoor activities. Limit "screen" time. Watch some programs with your pre-teen and discuss the program. Television, electronic games, and computers in your child's bedroom are strongly discouraged as these are associated with increases in body weight. To reinforce this, fairness is advisable. No one at home should have these items in the bedroom.

Safety Tips

• Accidents are the number one cause of death in children.
• Kids like to take risks at this age but are not well prepared to judge the degree of those risks. Therefore, eleven- and twelve-year-olds still need supervision. Parents should model safe choices.
• Car Safety
  - Everyone in a car should always wear seat belts or be in an appropriate booster seat.
• Pedestrian Safety
  - Make sure your child always uses a bicycle helmet. You can set a good example by always wearing one too.
  - Talk to your child about riding on busy streets.
  - Don't buy a bicycle that is too big for your child.
• Strangers
  - Discuss safety outside the home with your child.
  - Make sure your child knows her address, phone number, and her parents' places of work.
  - Remind your child never to go anywhere with a stranger.

Smoking

• Most adult smokers started smoking as teens. Children at this age may begin smoking by trying to fit in with friends, or think it is a fun activity at parties. They may be curious about what it is like. They may think it will help them relax. They may do it as a way to rebel against their parents. Pre-teens and teens are not often concerned with future health problems. It may be more helpful to emphasize the negatives that your child can see and feel now:
  - Cigarettes do not smell good. The smell will get into your child's clothes, room, hair, and breath.
  - Your child will be force to smoke outside (even when it is cold) away from other people. Your child may not be able to participate in certain events because she smokes.
  - Cigarettes cost a lot of money. An average smoker spends at least $2500 a year on cigarettes. Your child can probably think of many other ways to spend her money.
• If you smoke as a parent, set a quit date and stop. Set a good example for your child. If you cannot quit, do NOT smoke in the house or near children.

Immunizations

These immunizations are recommended for children entering seventh grade, usually at eleven or twelve years of age:

• Tdap booster for tetanus, diphtheria, and pertussis.
• Menactra (meningococcal meningitis) vaccine.
• HPV (human papillomavirus) vaccine is recommended for eleven- to twelve-year-olds. This is a vaccine that protects against sexually transmitted genital warts and cervical cancer. The vaccine is given in a three-dose series. Ask your healthcare provider for more information about HPV vaccine and the diseases against which it protects.
• An annual flu vaccine is recommended.

Next Visit

The American Academy of Pediatrics recommends that your child have a check-up every year.

What to Expect as Your Child Grows:
Well Child Care at 13-14 Years

Nutrition Nutrition is very important for children at this age. They are growing rapidly and growing more independent. Teenagers eat many meals outside the house. Encourage them to make healthy choices. Purchase plenty of fruits, vegetables, calcium-rich foods, and iron-rich foods (especially meats, nuts, soy, and iron-enriched cereals). The best way to get your teenager to eat well is to be a good role model. Encourage family meals and have open ended conversations about making good food choices. This is one way to make sure teens are consuming a nourishing diet.

Development

• Most girls and some boys are well into the rapid physical growth of adolescence. Expect growth spurts. Ask your healthcare provider if you have specific questions about your children's physical and emotional changes as they mature.
• School achievement is very important at this age. Many experience anxiety due to increased social and academic stressors. Stay involved with your child's schoolwork and be a cheerleader- rewarding efforts and achievements with praise.
• Your child may struggle with a sense of identity. The need to fit in becomes more important. Talk with your child about peer pressure. Watch for signs of changes in your child's normal behaviors that go against the family’s value system. Your child may be influenced by friends to try risky behaviors (alcohol, tobacco, sex).
• Encourage open communication regarding sexuality with your adolescent. Teens may start to look for loving relationships outside of the family.

Behavior and Discipline

• At this age, peer pressure can be hard to resist. To prevent problems, get to know your child's friends and their parents. Children who are most successful at resisting negative peer pressure are those with a strong self-concept who have the confidence to say "No."
• Your child may be opinionated and challenge family rules and values.
• You should continue to set limits and enforce consequences. Your child may feel that you are preventing him from doing things independently. This can help your child avoid errors in judgment that could have lifelong repercussions.

Safety Tips

• Accidents are the number one cause of death in adolescent children.
• Kids like to take risks at this age but are not well prepared to judge the degree of those risks.
• Everyone in a car should always wear a seat belt.
• Make sure your child always uses a bicycle helmet. You can set a good example by always wearing a helmet.
• Remind your child about riding on busy streets.
• If you have a gun at home, make sure it is locked up.

Smoking, E-Cigarettes & Vaping

• Most adult smokers started smoking as teens. Children at this age may begin smoking by trying to fit in with friends. They may be curious about what it is like or do it as a way to rebel against their parents. Pre-teens and teens are not often concerned with future health problems. It may be more helpful to emphasize the negatives that your child can see and feel now:
• Cigarettes do not smell good. The smell will get into your child's clothes, room, hair, and breath.
• Your child will be force to smoke outside (even when it is cold) away from other people. Your child may not be able to participate in certain events because she smokes.
• If you smoke as a parent, set a quit date and stop. Set a good example for your child. If you cannot quit, do NOT smoke in the house or near children.
• Vaping may seem like a good alternative to cigarettes. However, the long term health effects are still unknown.
• E-Cigs come in different shapes. Some are made to look like a pen, a memory stick, key fob and even an inhaler.

Immunizations

• Gardasil (human papillomavirus vaccine) is recommended for children eleven- to twelve-year-olds. This is a vaccine that protects against sexually transmitted warts and cervical cancer. We routinely give at the 13-14 year visit. The vaccine is given in a two-dose series if given before the age of 15. Ask your healthcare provider for more information about HPV vaccine.
• Children over six months of age should receive an annual flu shot.

Next Visit

The American Academy of Pediatrics recommends that your child have a routine check-up every year.