Age: 6 Years

“What can I do?” is the pressing question for 6 year-olds. They are continuously testing what their bodies can do, “How fast can I run?” or “How far can I kick this ball?” Their coordination and, consequently, confidence is improving. They want to be independent, but do not consistently make good decisions. Be warned, 6 year-olds often suffer from “lie-a-rrhea.”

SAFETY

1. Car: Whether you are using a convertible car seat (this is the big, heavy, 5 point harness style seat) or a backed booster in the back seat of the vehicle entirely depends on the seat you have and the size of your child.

   1. Important Note: As of 11/2018, the American Academy of Pediatrics (AAP) recommends children stay in the most restrictive seat possible until they reach the highest weight or height allowed by their seat. This replaces the previous recommendation of moving to a booster at 4 years and 40 lb.

   2. A small 6 year-old (or if you have a large convertible seat) will still be in a 5 point harness convertible seat at this age. However, most kids will have transitioned to a backed booster seat that utilizes the seat belt for restraint.

2. Strangers: Reinforce stranger safety (e.g., never opening the door to strangers, getting in stranger’s cars, etc.). Identify who your child can consider a safe adult should he or she get lost.

3. Adults: Teach rules on safety with other adults.

   1. No adult should tell a child to keep secrets from parents.

   2. No adult should ask to see/touch private parts (either the child’s or the adult’s).

4. Smoking: Make sure your home and cars are smoke-free zones. Also, check smoke alarms to ensure that they work properly, and change batteries annually.

5. Water: Teach your child to swim. Do not allow children to swim unattended. Teach your child to put on sunscreen.

6. Helmets: Wear a helmet on all things a kid can ride (e.g., bicycles, tricycles, scooters, ATVs, etc.).

7. Guns: Lock guns with ammunition separate and in a gun safe. (Disturbing Fact: More children are killed from guns every year than are intruders.).

8. Household: Reinforce home safety rules: Don’t play with matches, electrical tools, etc. Teach emergency numbers (e.g., 911).

9. Street Safety: Teach your child rules to getting to and from school safely, including pedestrian safety.

Nutrition

1. Provide 3 meals and 1-2 nutritious snacks a day.

2. Limit the number of fats and sweets your child gets in a day. In addition, you child does not need juice, it is essentially fruit sugar. If you choose to give it to your child, do so in limited quantities (e.g., 4 oz a day). There is no place for soft drinks/soda in a child’s diet.

3. Engage your child in helping choose the menu and choosing foods that are “good for our bodies.” Offering good nutrition at an early age builds good lifetime eating habits. Consider the fact that you’re fueling your child’s growing brain. As a society, we are propagating this notion of “kid food” (e.g., mac n’ cheese, hot dogs, French fries, chicken nuggets). These have very little nutritional value. Offer a variety of foods rich in fruits and vegetables. Also try to include foods rich in protein.

4. Dairy products should be low fat. If your child isn’t a big milk drinker, just ensure your child is getting enough calcium and vitamin D from other sources (e.g., almond milk, dark leafy greens, milk products, supplements, etc.).

5. Eat meals as a family (around a table with no media). Not only does eating together as a family develop good nutritional habits, it has multiple lasting effects on the social support of a family.

6. Model good eating habits. Teach the concept of listening to our body’s hunger cues (e.g., eat when you are hungry, stop when you are satisfied).

7. Keep in mind it is very difficult to eat healthy when eating out (especially at fast food restaurants).

8. Give a multivitamin daily only if your child is not eating a balanced diet.

Sleep

Children this age need 9-12 hours of sleep at night. Should be sleeping independently in own bed.

Milestones

1. Can write name.

2. Can write letters and numbers (some may be backwards).

3. Can count beyond 20.

4. Draws a person with 6+ body parts.

5. Starting to read.

6. Plays make-believe.

7. Can get dressed without help.

8. Knows address and phone number.

9. Hops, skips, and can balance on one foot.

10. Speech should be 100% understandable without articulation difficulties.

ORAL HEALTH

1. Continue to brush twice daily and floss once a day.

2. Should continue to see a dentist every 6 months.

3. Fluoride supplementation depends on the level of fluoride in the drinking water in the city where you live (your pediatrician or dentist can prescribe it if needed).

OTHER

1. Media Exposure: Set limits on total media time, type of media, and review content. Try to co-view media. Create media free zones in the household (e.g., no media at the table or in bedrooms). Ensure that media use isn’t interfering with sleep, school/homework, play, activities, or family time. Utilize safe guards on computers and devices to limit type of content brought into the home.

2. Sexual Education: Answer questions at a level appropriate for your child’s understanding. Be direct and honest. You may want to have some age-appropriate sex education books or books about bodies to help answer questions. Always use the correct anatomical terms. Teach that certain body parts (those covered by a bathing suit) are private and should never be touched without the child’s permission.

3. Social Interactions: Praise your child for accomplishments. Encourage your child to talk about feelings and experiences at school and with friends. Provide opportunities for your child to interact with other children and learn teamwork. Ensure that you know your child’s friends and their families. Discuss bullying at this age.

4. Learning Experiences: Read together every day. Listen as your child begins to read aloud. Visit libraries, parks, museums.

5. Discipline: Set limits. Be consistent. Ensure your child knows the house rules (e.g., bedtime rules, respect for others). Teach natural consequences for unacceptable behavior. Set reasonable expectations. Teach how to resolve conflicts and handle anger.

6. Chores: Give your child some age appropriate chores and household responsibilities (e.g., help set the table, keep own room clean, put away laundry, etc.). Teach your child responsibility for personal belongings.

7. School: Meet with your child’s teacher. Become involved with school.

Illness

Treat fever and minor illnesses at home as long as your child looks and acts ok. Bring your child to the doctor if: symptoms are severe or prolonged (e.g., fever beyond 5 days, bad cough, etc.), your child has signs of dehydration, your child reports specific symptoms (e.g., sore throat, hurt arm, etc.), your child has difficult or labored breathing, your child is lethargic, or you are concerned.

YOUR NEXT VISIT

Your child’s next well child check is in 1 year. If all vaccines are up to date, your child should not need any shots aside from an annual flu shot at the next visit.

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