MIDDLE CHILDHOOD

Screening and Assessment

• If a child wants to participate in a sports program, a preparticipation physical examination may be useful. In addition to the screening and assessment guidelines that follow, health professionals can refer to resources such as a preparticipation physical evaluation.4
  
  
• Obtain a complete medical history of the child, including (1) history of previous injuries and hospitalizations, (2) family history of sudden cardiac death, and (3) history of dizziness or fainting during or after physical activity.4 You may want to inquire about conditions affecting sports participation.5, 6
  
  
• Measure the child's height and weight, and plot these on a standard growth chart (see Tool H: CDC Growth Charts). Deviation from the expected growth pattern (e.g., a major change in growth percentiles on the chart) should be evaluated. This may be normal or may indicate a problem (e.g., difficulties with eating).
  
  
• Height and weight measurements can be used to indicate nutrition and growth status. Changes in weight reflect a child's short-term nutrient intake and serve as general indicators of nutrition status and overall health. Low height-for-age may reflect long-term, cumulative nutrition or health problems.
  
  
• Body mass index (BMI) can be used as a screening tool to determine nutrition status and overall health. Calculate the child's BMI by dividing weight by the square of height (kg/m2) or by referring to a BMI chart. Compare the BMI to the norms listed for the child's sex and age on the chart. (See the Obesity chapter.)
  
  
• Some children have a high BMI because of a large, lean body mass resulting from physical activity, high muscularity, or frame size. An elevated skinfold (i.e., above the 95th percentile on CDC growth charts) can confirm excess body fat in children.
  
  
• Assess the child's general health status, including medical conditions and recent illnesses. Assess the child's cardiovascular, pulmonary, and musculoskeletal systems. Obtain the child's blood pressure.
  
  
• Determine whether the child is taking any medications.
  
  
• Assess the child's motor skill development (Table 11).
  
  
• Assess the child's physical maturity.
  
  
• Assess the child's level of physical activity by
  • Determining how much physical activity the child participates in on a weekly basis.
  • If possible, evaluating how the child's physical fitness compares to national standards (e.g., by reviewing the results of the child's President's Council on Physical Fitness and Sports test).

   

  Table 11. Motor Skill Development During Middle Childhood

  Age Range	Motor Skills Being Developed	Appropriate Physical Activities
  5–6 Years	Fundamental (e.g., running, galloping, jumping, hopping, skipping, throwing, catching, striking, kicking)	Activities that focus on having fun and developing motor skills rather than on competition Simple activities that require little instruction Repetitive activities that do not require complex motor and cognitive skills (e.g., running, swimming, tumbling, throwing and catching a ball)
  7–9 Years	Fundamental Transitional (e.g., throwing for distance; throwing for accuracy)	Activities that focus on having fun and developing motor skills rather than on competition Activities with flexible rules Activities that require little instruction Activities that do not require complex motor and cognitive skills (e.g., entry-level baseball, soccer)
  10–11 Years	Transitional Complex (e.g., playing basketball)	Activities that focus on having fun and developing motor skills rather than on competition Activities that require entry-level complex motor and cognitive skills Activities that continue to emphasize motor skill development but that begin to incorporate instruction on strategy and teamwork

   

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