This story is the fourth in a six-part series featuring Novant Health pediatricians helping parents navigate their child’s development and telling them what to look for at each stage, from birth to adulthood.

The 6-to-10-year age range often begins as a time of fun for children and their parents, said Dr. Ann Condon of Novant Health Lakeside Pediatrics - Denver, located in North Carolina. Kids become immersed in school, making friends and riding their bikes. But around the age of 9 or so, Condon said, things often get a little more challenging as children often start going through an awkward phase.

The good news there, she added, is that families and their doctors are usually able to have some of their best discussions in the 6-to-10 age range as there tend to be fewer vaccinations and school-entry forms to manage during visits.

At this age, children should see their pediatrician once a year for a physical and in the fall for a flu shot, Condon said. Some common questions she encourages parents of elementary school age children to ask their pediatrician:

Is my child getting enough sleep?

“A lot of kids are sleep-deprived in the age range of 6 to 10, and sleep deprivation can lead to kids being overweight or having poor school performance,” Condon said. The problem, she said, is that there are too many distractions.

  “They’re so plugged into video games or tablets … that they aren’t really going to bed at the time that they should be.” Just as important, she added, a lot of kids are overscheduled. “They come home (from school) and they’re going to this practice or that practice.” And then many are up late watching TV. She said the American Academy of Pediatrics (AAP) recommends children at this age sleep 9 to 12 hours per day.  

The solution to getting more sleep

Condon said children shouldn’t use electronic devices or watch TV for 90 minutes prior to going to bed. Screen time, she said, is a common reason kids have trouble sleeping.

“A lot of parents aren’t aware of the effects screens can have on sleep and say, ‘OK, you can watch one TV show before you go to bed,’ and that’s actually the worst thing you can do for your kids when it comes to screen time because it actually ramps kids up before they go to bed.”

Recent studies have shown links between screen time use and loss of sleep and the AAP also recommends parents require their kids to put away their electronic devices before going to their bedrooms at night.

What should my child be eating?

As with some of the preceding age ranges, Condon recommends parents follow the 5:2:1:0 rule with their children. That means five servings of fruits and vegetables a day, no more than two hours of screen time, at least one hour of physical activity and zero sugary drinks, including juice. Those numbers of fruits and vegetables and cutting sugary drinks are important for combatting obesity, she said.  

What if my child is participating in sports ?

“It’s great for kids to stay active. If they’re going to be playing a sport, kids and their parents should let their pediatrician know that because they should have certain things done for that particular sport,” Condon said. “We’re focusing a lot on concussions now. It’s very important to have a baseline concussion screening. Novant Health also has specialists in pediatric sports medicine , but a physical should be done by a pediatrician, too.” 

Later in the 6-10 age range, some newer concerns will crop up as many kids, especially young girls, begin going through growth spurts and the early stages of puberty. Condon said parents and their children usually start asking puberty questions around ages 9 and 10, which is around fourth grade, and it usually begins with asking if the child is ready for deodorant. (Your nose will tell you, she said.)

Talking with your child about sex can often wait until just before middle school, Condon said. But she said some parents may want to consider discussing it a bit earlier if the child has older siblings.

Condon recommends parents of both boys and girls visit, a site for parents founded by the American Academy of Pediatrics. As for book recommendations for the kids themselves for the age range, she strongly recommends for girls the book series, “The Care and Keeping of You,” which begins with a book for girls 8 and up. For boys, she recommends “The Boys Body Book.”