SECTION 115.26. Grade 6, Adopted 2020

(a) Introduction.

(1) The goal of health education is to provide instruction that allows youth to develop and sustain health-promoting behaviors throughout their lives. The understanding and application of these standards will allow students the ability to gather, interpret, and understand health information; achieve health literacy; and adapt to the ever-evolving science of health. The health education knowledge and skills should be presented to students in a positive manner to support the development of a healthy self-concept and responsible decision making. The standards will help students reinforce, foster, and apply positive character traits.

(2) There are essential skills that repeat throughout the six strands and embody the interconnection of health literacy. These skills include decision making, problem solving, goal setting, maintaining healthy relationships with self and others, seeking help and support, and recognizing various influences on health such as social, environmental, media, and genetic. These skills, developed early on and reinforced throughout a student's education, will foster mastery of health concepts. Health class educators are encouraged to partner with school counselors where available to schedule time for them to deliver classroom guidance lessons to help teach these essential competencies. In addition, areas in the standards related to abuse, neglect, violence, loss, grief, trauma, and suicide may directly affect some students in the classroom. Should the educator recognize signs of discomfort with instruction in these areas, students should be referred to the appropriate resource, identified ahead of such instruction, for additional help and support.

(3) Students gain an understanding of health information and skills through six strands: physical health and hygiene; mental health and wellness; healthy eating and physical activity; injury and violence prevention and safety; alcohol, tobacco, and other drugs; and reproductive and sexual health.

(A) Physical health and hygiene education helps to prepare students for improved lifelong health outcomes. Learning about body systems lays the foundation for personal health and hygiene. Health literacy and preventative behaviors empower students to make informed choices to support self, family, and community.

(B) The mental health and wellness strand recognizes that the knowledge and skills necessary to manage emotions, reactions, and relationships are essential to reaching one's full potential. Students gain knowledge about social and emotional health, including developing a healthy self-concept, understanding risk and protective factors, and identifying and managing mental health and wellness concerns. In the early grades, students develop fluency around emotions and self-regulation and understand the relationship between feelings, thoughts, and behavior. In subsequent grades, students learn and practice appropriate ways to solve interpersonal conflicts, work to develop a positive self-image, and develop healthy self-management skills.

(C) The healthy eating and physical activity strand addresses the importance of nutrition and physical activity to support a healthy lifestyle. Students apply critical-thinking and decision-making skills to make positive health choices. Students learn about essential nutrients, food groups, portion control, government nutritional recommendations, and the health benefits of being physically active. Students evaluate the connection between physical activity and nutrition and the prevention of chronic diseases.

(D) By focusing on injury and violence prevention and safety, the standards promote student well-being and awareness of dangerous situations. Supporting student well-being and providing instruction in digital citizenship, bullying prevention, first aid, and identification of safe and unsafe situations creates empowered and educated students who are able to make decisions that keep themselves and others safe. Beginning in Kindergarten and continuing through high school, students gain knowledge and skills to support safety and wellness at school, at home, online, and in the community.

(E) The standards under the alcohol, tobacco, and other drugs strand focus on a number of protective factors that develop empowered students who are able to make better-informed decisions, including understanding the impact of substance use on physical, mental, and social health. Through this strand, students learn key concepts about alcohol, tobacco, and other drugs, including the use, misuse, and physiological effects; short- and long-term impacts on health; treatment; risk and protective factors; and prevention. These concepts introduce healthy alternatives and ways for students to ask for and seek out help from parents and other trusted adults.

(F) Beginning in Grade 4, students learn about changes associated with adolescent development in the reproductive and sexual health strand. In subsequent grade levels, students identify the purpose of these changes and their role in fertilization and reproduction. Students learn the characteristics of healthy and unhealthy relationships and how to use communication and refusal skills to set personal boundaries in dating/romantic relationships. Students also identify how to respond to sexual harassment and abuse.

(4) An integral part of health education involves educators being aware of state laws relevant to human sexuality instruction. These laws include affirming:

(A) a local school district's control over the provision of human sexuality instruction to ensure that local community values are reflected in that instruction (Texas Education Code (TEC), §28.004(e)-(h));

(B) the right of a parent or legal guardian to be informed of the provision of human sexuality instruction to their child and review the content of that instruction (TEC, §28.004(i)-(j));

(C) the right of a parent or legal guardian to remove their child from any portion of human sexuality instruction without penalty to the child (TEC, §28.004(i));

(D) the centrality of abstinence education in any human sexuality curriculum (TEC, §28.004(e)); and

(E) the right of a parent or legal guardian to be informed of and consent to an abortion performed on their pregnant child (with judicially authorized or medical emergency exceptions) (Texas Family Code, Chapter 33).

(5) Educators also should be aware of and abide by the statutory prohibition on taxpayer resource transactions between state governmental entities, including public schools, and abortion providers or an affiliate of an abortion provider (Texas Government Code, Chapter 2272).

(6) Statements containing the word "including" reference content that must be mastered, while those containing the phrase "such as" are intended as possible illustrative examples.

(7) Students should first seek guidance in the area of health from a parent or legal guardian.

(b) Knowledge and skills.

(1) Physical health and hygiene--body systems. The student examines the structure, function, and relationships of body systems and their relevance to personal health. The student is expected to explain how to maintain the healthy status of body systems.

(2) Physical health and hygiene--personal health and hygiene. The student understands health literacy, preventative health behaviors, and how to access and evaluate health care information to make informed decisions. The student is expected to:

(A) compare immediate and long-term effects of personal health care choices such as personal and dental hygiene;

(B) develop criteria for evaluating the validity of health information and sources;

(C) describe ways to demonstrate decision-making skills based on health information;

(D) identify current health-related issues and recommendations or guidelines;

(E) explain the role of preventive health measures, immunizations, and treatment such as wellness exams and dental check-ups in disease prevention;

(F) describe actions that should be taken when illness occurs, including asthma, diabetes, and epilepsy; and

(G) describe and recognize the signs, symptoms, and treatments of vector-borne illnesses such as Lyme disease or West Nile Virus.

(3) Mental health and wellness--social and emotional health. The student identifies and applies strategies to develop socio-emotional health, self-regulation, and healthy relationships. The student is expected to:

(A) demonstrate healthy methods for communicating emotions in a variety of scenarios;

(B) assess and demonstrate healthy ways of responding to conflict;

(C) differentiate between positive and negative peer influence;

(D) describe methods for communicating important issues with and understanding perspectives of parents and peers;

(E) discuss and demonstrate how to listen and respect others' feelings and perspectives in a variety of scenarios; and

(F) identify strategies for using non-violent conflict resolution skills.

(4) Mental health and wellness--developing a healthy self-concept. The student develops the capacity for self-assessment and evaluation, goal setting, and decision making in order to develop a healthy self-concept. The student is expected to:

(A) identify how physical and social changes impact self-esteem;

(B) identify possible health benefits of setting and implementing long-term personal goals;

(C) create and discuss personal life goals that one wishes to achieve and consider the financial impact of graduating from high school, having a full-time job, and waiting until marriage if one plans to have children; and

(D) explain the steps in the decision-making process and the importance of following the steps.

(5) Mental health and wellness--risk and protective factors. The student recognizes the influence of various factors on mental health and wellness. The student is expected to:

(A) identify and discuss how adolescent brain development influences emotions, decision making, and logic; and

(B) relate physical environmental factors such as school climate and availability of resources to individual, family, and community health.

(6) Mental health and wellness--identifying and managing mental health and wellness concerns. The student develops and uses appropriate skills to identify and manage conditions related to mental health and wellness. The student is expected to:

(A) examine the outcomes of healthy and unhealthy methods for managing challenges related to long-term health conditions of self and others;

(B) identify and describe lifetime strategies for managing conditions that impact learning such as attention-deficit disorder (ADD), attention-deficit/hyperactivity disorder (ADHD), dyslexia, dysgraphia, and sensory issues;

(C) identify how to respond positively to develop resiliency;

(D) describe healthy and unhealthy self-management strategies for stress, anxiety, depression, trauma, loss, and grief;

(E) identify causes and effects associated with disordered eating and eating disorders such as bulimia, anorexia, and binge eating disorder and the importance of seeking help from a parent or another trusted adult for oneself or others related to disordered eating;

(F) discuss the suicide risk and suicide protective factors identified by the Centers for Disease Control and Prevention (CDC) and the importance of telling a parent or another trusted adult if one observes the warning signs in self or others;

(G) explain the role of a healthy self-concept in avoiding self-harming behaviors that can occur when someone is struggling to manage overwhelming emotions; and

(H) identify suicide prevention resources such as the National Suicide Prevention Hotline.

(7) Healthy eating and physical activity--food and beverage daily recommendations. The student analyzes and applies healthy eating strategies for enhancing and maintaining personal health throughout the lifespan. The student is expected to:

(A) define micronutrients, including calcium and iron, and their recommended daily allowances;

(B) compare and contrast common food labels and menus for nutritional content and calories;

(C) describe healthy and unhealthy dietary practices;

(D) explain the importance of a realistic personal dietary plan; and

(E) evaluate the importance of choosing lower sodium alternatives to foods that have high levels of sodium such as salty snacks and canned vegetables.

(8) Healthy eating and physical activity--physical activity. The student identifies, analyzes, and applies strategies for enhancing and maintaining optimal personal physical fitness throughout the lifespan. The student is expected to:

(A) identify the CDC guidelines for daily physical activity throughout the lifespan; and

(B) analyze the benefits of regular physical activity on mental, physical, and social health.

(9) Healthy eating and physical activity--nutrition and physical activity literacy. The student obtains, processes, and understands basic physical activity and nutrition information needed to make health-promoting decisions. The student is expected to:

(A) make a variety of healthy personal food choices and develop short- and long-term goals to achieve appropriate levels of physical activity and improve personal physical fitness levels; and

(B) explain the role of media and technology in influencing individual and community health related to physical activity and nutritional choices.

(10) Healthy eating and physical activity--risk and protective factors. The student analyzes and applies risk and protective factors related to healthy eating and physical activity. The student is expected to:

(A) analyze the impact of moderate physical activity and dietary choices on the prevention of obesity, heart disease, and diabetes;

(B) identify strategies to adopt healthy behaviors to reduce the likelihood of developing chronic conditions such as obesity, heart disease, or diabetes;

(C) analyze internal and external factors that influence healthy eating and physical activity behaviors; and

(D) discuss the nutritional differences between preparing and serving fresh or minimally processed foods and commercially prepared or highly processed foods.

(11) Injury and violence prevention and safety--safety skills and unintentional injury. The student identifies and demonstrates safety and first aid knowledge to prevent and treat injuries. The student is expected to describe basic first-aid procedures.

(12) Injury and violence prevention and safety--healthy home, school, and community climate. The student understands that individual actions and awareness can impact safety, community, and environment. The student is expected to:

(A) discuss and demonstrate strategies for avoiding violence, gangs, weapons, and human trafficking;

(B) define safe haven and identify dedicated safe haven locations in the community;

(C) describe the dangers associated with a variety of weapons;

(D) explain the importance of complying with rules prohibiting possession of weapons; and

(E) create a personal safety plan.

(13) Injury and violence prevention and safety--digital citizenship and media. The student understands how to be a safe and responsible citizen in digital and online environments. The student is expected to:

(A) discuss appropriate personal digital and online communication boundaries;

(B) develop strategies to resist inappropriate digital and online communication such as social media posts, sending and receiving photos, sexting, and pornography;

(C) discuss and analyze consequences resulting from inappropriate digital and online communication such as social media posts, sending and receiving photos, sexting, and pornography;

(D) discuss strategies and techniques for identity protection in digital and online environments;

(E) identify how technology is used to recruit or manipulate potential victims of sex trafficking; and

(F) identify the current legal consequences of cyberbullying and inappropriate digital and online communication.

(14) Injury and violence prevention and safety--interpersonal violence. The student understands the impact of interpersonal violence and the importance of seeking guidance and help to maintain personal safety. The student is expected to:

(A) identify how exposure to family violence can influence behavior and the importance of reporting suspected abuse;

(B) assess healthy and appropriate ways of responding to and discouraging bullying and cyberbullying, including behavior that takes place at school;

(C) analyze the impact that bullying has on both victims and bullies;

(D) identify strategies for prevention and intervention of all forms of bullying and cyberbullying such as emotional, physical, social, and sexual; and

(E) discuss ways to seek the input of parents and other trusted adults in problem solving issues relating to violence and bullying.

(15) Alcohol, tobacco, and other drugs--use, misuse, and physiological effects. The student understands the difference between use and misuse of different substances and how the use and misuse of substances impacts health. The student is expected to:

(A) describe the misuse and abuse of prescription and over-the-counter drugs, including combining drugs, and the dangers associated with each;

(B) compare and contrast examples of prescription and over-the-counter drug labels;

(C) identify and describe practices used to safely store and properly dispose of prescription and over-the-counter drugs; and

(D) describe substance abuse and addiction to alcohol, vaping products, tobacco, other drugs, and dangerous substances.

(16) Alcohol, tobacco, and other drugs--short- and long-term impacts. The student identifies and analyzes the short- and long-term impacts of the use and misuse of alcohol; tobacco; drugs, including prescription drugs; and other substances. The student is expected to:

(A) describe the short- and long-term health consequences of prescription and over-the- counter drug misuse and substance use disorders; and

(B) discuss the legal consequences related to the use, misuse, and possession of drugs, including prescription drugs.

(17) Alcohol, tobacco, and other drugs--treatment. The student recognizes and understands the options for treatment and how to seek help related to the use and misuse of alcohol; tobacco; drugs, including prescription drugs; and other substances. The student is expected to:

(A) identify ways to report a suspected abuse of drugs to a parent, school administrator, teacher, or another trusted adult;

(B) identify signs and symptoms of alcohol; tobacco; drugs, including prescription drugs; and other substance use and misuse such as using medicine prescribed for someone else or for reasons other than intended;

(C) identify examples of who, when, where, and how to get help related to unsafe situations regarding the use and misuse of alcohol; tobacco; drugs, including prescription drugs; and other substances.

(18) Alcohol, tobacco, and other drugs--risk and protective factors. The student understands how various factors can influence decisions regarding substance use and the resources available for help. The student is expected to:

(A) explain the impact of peer influence on decision making regarding the use of alcohol, tobacco, and other drugs;

(B) describe methods for differentiating between positive and negative relationships that can influence alcohol, tobacco, and other drug use;

(C) identify physical and social influences on alcohol, tobacco, and other drug use behaviors; and

(D) explain the relationships between alcohol, tobacco, drugs, and other substances and the role each can play in unsafe situations such as drinking and driving.

(19) Alcohol, tobacco, and other drugs--prevention. The student analyzes information and applies critical-thinking skills to avoid substance use and misuse and recognizes the benefits of delayed use. The student is expected to:

(A) identify ways such as alternative activities and refusal skills to prevent or avoid the use of alcohol, tobacco, drugs, and other substances;

(B) demonstrate refusal skills in various scenarios where alcohol, tobacco, and other drugs may be present; and

(C) identify and describe strategies for avoiding alcohol, tobacco, and other drugs, including opioids.

(20) Reproductive and sexual health--healthy relationships. The student understands the characteristics of healthy romantic relationships. The student is expected to:

(A) define and distinguish between friendship, infatuation, dating/romantic relationships, and marriage;

(B) describe how friendships provide a foundation for healthy dating/romantic relationships;

(C) list healthy ways to express friendship, affection, and love;

(D) describe characteristics of healthy dating/romantic relationships and marriage, including sharing, kindness, honesty, respect, trust, patience, communication, and compatibility;

(E) explain that each person in a dating/romantic relationship should be treated with dignity and respect; and

(F) describe how healthy marriages can contribute to healthy families and communities.

(21) Reproductive and sexual health--personal safety, limits, and boundaries. The student understands how to set and respect personal boundaries to reduce the risk of sexual harassment, sexual abuse, and sexual assault. The student is expected to:

(A) identify that physical, emotional, and sexual abuse and exploitation are all forms of abuse;

(B) identify the social and emotional impacts of sexual harassment, sexual abuse, sexual assault, and sex trafficking;

(C) list the characteristics of unhealthy or harmful relationships, including anger, controlling behavior, jealousy, manipulation, and isolation;

(D) identify ways of reporting suspected sexual abuse involving self or others such as telling a parent or another trusted adult;

(E) explain how a healthy sense of self and making and respecting decisions about safe boundaries and limits promote healthy dating/romantic relationships;

(F) identify communication and refusal skills and how they can be applied in dating/romantic relationships; and

(G) explain the importance of clearly communicating and respecting personal boundaries and using refusal skills related to physical intimacy such as holding hands, hugging, and kissing.

(22) Reproductive and sexual health--anatomy, puberty, reproduction, and pregnancy. The student analyzes adolescent development, the process of fertilization, and healthy fetal development. The student is expected to:

(A) describe changes in male and female anatomy and physiology during puberty and how rates and patterns of development can vary between individuals;

(B) describe the process, characteristics, and variations of the menstrual cycle;

(C) analyze the role of hormones related to growth and development and personal health;

(D) describe the cellular process of fertilization in human reproduction; and

(E) explain significant milestones of fetal development.

(23) Reproductive and sexual health--sexual risk. The student understands that there are risks associated with sexual activity and that abstinence from sexual activity is the only 100% effective method to avoid risks. The student is expected to:

(A) identify teen pregnancy as a possible outcome of sexual activity;

(B) identify life goals that one wishes to achieve prior to becoming a parent;

(C) define sexually transmitted infections (STIs) and sexually transmitted diseases (STDs) as infections or diseases that are spread through sex or sexual activity;

(D) identify what emotional risks are associated with sexual activity between unmarried persons of school age;

(E) define abstinence as refraining from all forms of sexual activity and genital contact between individuals and discuss the importance of seeking support from parents, other trusted adults, and peers to be abstinent;

(F) explain why abstinence is the preferred choice of behavior in relationship to all sexual activity for unmarried persons of school age;

(G) identify why abstinence from sexual activity is the only method that is 100% effective in preventing pregnancy; STDs/STIs, including human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS); and the emotional risks associated with adolescent sexual activity;

(H) list the benefits of abstinence from sexual activity such as increased self-esteem, self-confidence, student academic achievement, and alignment with personal, family, and moral or religious beliefs and values; and

(I) explain how laws protect victims of sexual harassment, sexual abuse, and sexual assault.

Source Note: The provisions of this §115.26 adopted to be effective August 1, 2022, 46 TexReg 2756