Well Child Care at 9 Years

9 yr milestones

Nutrition

Mealtime is an important experience for a 9 year old. Use this time to discuss the events of the day and how your child is feeling.

Children watch what their parents eat, so set a good example. Choose meals that have foods from all food groups: meats, dairy products, fruits, vegetables, and cereals and grains. Most children should limit the intake of fatty foods.

Children over 2 years of age usually should drink low-fat or skim milk, depending on their need for calories. Milk is still important for healthy bones. Keep healthy snacks on hand. Kids should drink soda pop rarely.

Development

Growth in height and weight during this year should remain steady. If your child has rapid weight gain or no weight gain for more than 4 months, then you should check with your doctor. A few girls will start into their pubertal growth spurt.

Kids usually have a lot of energy during this part of childhood. Make sure they have lots of chances to run and play outdoors.

Social Skills

Finding compatible friends is very important. Children at this age are imaginative and get along well with friends their own age. They are becoming very concerned about what other kids think about them. They are beginning to understand that the emotions others experience are similar to their own.

  • Talk with your child about both the enjoyable and difficult aspects of friendships.
  • Teach your child about helping people “save face” when they are angry or embarrassed.
  • Be sure your child has the opportunity to learn about leadership. Group activities allow your child the chance to learn leadership skills.

Behavior Control

Use encouraging words when speaking with your child. Kids have a strong need to feel like they are valued in the family and with their friends.

  • Tell your child everyday that you love him.
  • Find words that encourage schoolwork and friendships. Tell your child when you notice that he is on time or getting her work done on schedule.
  • Keep rules to a minimum and make sure they are fair and consistently enforced. Remember to use your attention, as much as possible, to “catch the child being good.” The role of peers is often great, and children may resist adult authority at times.
  • Teach your child to apologize and require that your child help people who they have hurt.
  • Help your child develop a strong sense of right and wrong.
  • Don’t make demands upon your child that are above his ability.
  • Allow your child some choice when alternatives exist.
  • Don’t allow competition to get out of hand. Allow a child to compete against himself and set personal best records.

The ingredients to build a strong conscience include a warm and caring family, a strict code of conduct, and consistent and firm enforcement of the rules. Model how you wish your child to behave.

It is important to begin discussing sexuality. Children should be asked if they have any questions about sex. At first, they often don’t want to talk about sex. Do not impose information on them. Once kids realize that parents feel comfortable discussing sex, kids will often ask their parents for information. Parents and kids should discuss the values that parents want their children to have about sexuality.

Reading and Electronic Media

The elementary school years are a period which parents and children can enjoy reading together. Reading will promote learning in school, too. Make reading a part of the pre-bedtime ritual.

Limit TV, computers, and electronic game time to a total of 1 or 2 hours per day. Make sure that home computers have some kind of filter or parental control. Encourage participation in family games and other activities. Carefully select the programs you allow your child to view. Be sure to watch some of the programs with your child and discuss the show. Avoid violent programming and using the TV as an electronic babysitter. Do not put a television in your child’s bedroom.

Dental Care

  • Your child should brush his teeth at least twice a day and should have regular visits to the dentist.
  • Check your child’s teeth after he has brushed.
  • Flossing the teeth before bedtime is recommended.

Sealants (plastic coatings on the chewing surface of the molar teeth) may help prevent tooth decay. Ask your child’s dentist about this.

Safety Tips

Accidents are the number one cause of deaths in children. Kids like to take risks at this age but are not well prepared to judge the degree of those risks. Therefore, children still need close supervision at this age. Parents should model safe choices.

Fires and Burns

  • Practice a home fire escape plan.
  • Check your smoke detector battery.
  • Keep a fire extinguisher in or near the kitchen.
  • Teach child emergency phone numbers and to leave the house if fire breaks out.

Falls

  • Make sure windows are closed or have screens that cannot be pushed out.
  • Do not allow play in areas where a fall could lead to a serious injury.
  • Do not allow your child to play on a trampoline unsupervised.

Car Safety

  • Everyone in a car should always wear seat belts or be in an appropriate booster seat.

Pedestrian and Bicycle Safety

  • Supervise children when crossing busy streets. Children at this age will generally look in both directions, but they do not reliably look over their shoulders for oncoming cars.
  • Make sure your child always uses a bicycle helmet. Model this behavior when you ride a bicycle.
  • Your child is not ready for riding on busy streets. However, begin to teach your child about riding a bicycle where cars are present.
  • Purchase a bicycle that fits your child well. Don’t buy a bicycle that is too big for your child. Bikes that are too big are associated with a great risk of accidents.

Water Safety

  • Even children who are good swimmers need to be closely supervised around swimming pools and open water.

Strangers

  • Discuss safety outside the home with your child.
  • Make sure your child knows her address and phone number and her parents’ place(s) of work.
  • Teach 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. Ask your healthcare provider for help in quitting. If you cannot quit, do NOT smoke in the house or near children.
  • Teach your child that even though smoking is unhealthy, he should be civil and polite when he is around people who smoke.

Immunizations

An annual influenza shot is recommended for children up until 18 years of age. Additional vaccines are also sometimes given when children travel outside the country. The next routine vaccines are given to children at 11 years of age. Ask your doctor if you are uncertain if your child has received all recommended immunizations. Be sure to bring your child’s shot record to all visits with your child’s doctor.

Next Visit

The American Academy of Pediatrics recommends that your child’s next routine check-up be at 10 years of age.

Written by Robert Brayden, MD, Professor of Pediatrics, University of Colorado School of Medicine.
Pediatric Advisor 2012.2 published by RelayHealth.
Last modified: 2011-12-12
Last reviewed: 2011-12-14
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.

References
Pediatric Advisor 2012.2 Index