Developmental assessment and the School-Aged Child
Development is a continuous, orderly series of conditions that leads to activities, new motives for activities, and patterns of behavior Parthasarathy (2019). Paediatrics have different needs that vary in age and developmental stages. Every developmental stage comes with a particular set of challenges and accomplishments. Care of the client in a particular stage of development requires an understanding of the particular physical and psychosocial reactions that typically takes place with the client in that stage. The nurse must recognize the presence of expected developmental characteristics or signs of developmental delays.
Needs of a school-aged Child.
School aged child has a chronological age between 5-12 yrs. Health assessment provides key information needed for diagnosis of a child’s state and for planning his/her needs. All areas must be assessed and progression in each area supported. School aged children have variety of needs. According to Cherry (2014), Maslow’s hierarchy of needs is universal and applies to all humans from beginning of life to end of life. The need for Love and belonging especially from family and friendships, physiological needs are the basic needs like food water and shelter. Children have safety needs, they need to feel safe and right to be protected from harm. Self-esteem school-aged children is measured through academic performances, talents and skills through recognition. Self-actualization needs are succeed self-esteem. .
Varying physical assessments among school aged child.
Development can be categorized from various perspectives: physical, language, cognitive, social, and emotional. Each child’s development is unique; however, most children follow a typical developmental pattern. Physical assessment is a systematic approach proceeding from head to toe that is widely used.
Physical Milestones: Growth is slower in school age as compared to preschool period. Children are graceful and steady on their feet and elders of 10 years can participate sports activities. By the end of the period, boys and girls double their strength and physical abilities. There is decreased head circumference relative to height; proportional appearance. Loss of baby teeth and appearance of larger adult teeth is noted. Body systems, including immune system, gastrointestinal system, bladder capacity, and heart, become mature Scharf, Scharf, & Stroustrup, (2016). Bones are still developing and are subject to Structural changes from stresses.
Modifying Assessment Techniques
When communicating, it’s important to encouraging parents to talk about information that affects all aspects of the child’s life can be identified. Interviewing parents of younger school-aged, involves establishing a trusting relationship with the nurse. Begin the interview with an introduction; explain the nurse’s role and the purpose of the interview to establish a clear nurse to child/parent relationship. Use play with dolls or puppets with children; role playing may ease the anxiety of the interview process. Get on eye level with the child and actively engage children through play and verbal exchange. Treat adolescents appropriately, neither as children nor adults. Touch is a powerful communication tool, especially for the infant who calms when cuddled or patted, or a parent who is distraught about a child’s condition. Offer choices like use play or “storytelling”, photos, books videos, diagrams, establish limits, use play, introduce preparatory materials 1-5 days in advance of the event.
Typical Development of an 11 year Old Child
Characteristics demonstrated in this period are a blend of late childhood and early teen. Press (2015) argues that the child is between stages and is moving into a phase of seeking increased autonomy and independence while still needing parental approval and support. This child is experiencing adolescence changes related to puberty. Girls may experience menstruation. Teen behaviors may be demonstrated at one moment with highly dependent childhood behaviors displayed in the next. High-risk behaviors may be demonstrated by a child of this age in an attempt to show that he or she is “not a child.” Gay, lesbian, or bisexual child may experience barriers in developing self-identity.
Assessment using Erickson developmental theory.
According to Cherry (2018), Erickson stages of psychosocial development, classifies this child in the Industry vs. Inferiority stage. In this stage, the child is learning self-worth and developing talents. Nurses should allow the child to compete and cooperate on provide activities based on interest, talents, and abilities. Nurse should discuss condition openly with the child and allow privacy to discuss concerns. Encourage sibling and peer contact to promote love and belonging. Engage in conversations about his/her interests through use of videos to explain, foster independence.
Strategies used to gain cooperation; Treat the child as a partner equal to the nurse in the assessment. Find time without parents present to allow the preteen to ask questions or state concerns he/she may be embarrassed to discuss around parents. Attitude is also important in establishing a trust relationship. Maintaining a nonjudgmental manner will help the child feel comfortable and provide truthful information. Use of non-verbal communication such as smiling and maintaining a pleasant facial expression to reduce client anxiety.
Potential findings from the assessment; the child is able to think about own and the speech of others and to evaluate messages and correct if needed. Exhibits shyness due to anxiety as a result of adolescent changes. Verbalizes importance of a Peer group. He/she is able to identify with a sexual orientation.
References
Cherry, K. (2018). Erik Erikson’s Stages of Psychosocial Development. Retrieved June, 5, 2018.
Cherry, K. (2014). Hierarchy of needs. Retrieved Aug, 16, 2014.
Hockenberry, M. J., & Wilson, D. (2018). Wong’s nursing care of infants and children-E-book. Elsevier Health Sciences.
Parthasarathy, A. (2019). IAP Textbook of pediatrics. Jaypee Brothers, Medical Publishers Pvt. Limited.
Press, R. (2015). Developmental milestones of young children. Redleaf Press.
Scharf, R. J., Scharf, G. J., & Stroustrup, A. (2016). Developmental Milestones. Pediatrics in review, 37(1), 25-37.
