DEVELOPMENTAL ASSESSMENT AND THE SCHOOL-AGED CHILD NRS 434
Growth is defined as the continuous changes in size in both internal and external aspects. On the other hand, development is defined as the continuous process of adaptation throughout an individual’s lifespan (Scharf, Scharf & Stroustrup, 2016). Development progresses in a systematic sequence; however, each child advances through the predictable stages within a specific timeframe. School-aged children include children aged 6 to 12 years old. This paper seeks to compare the physical assessments among school-aged children, explain the typical developmental stages of a 6-year-old, and apply Erickson’s developmental theory to assess the child.
Physical Assessments among School-Aged Children
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The physical assessment of a school-aged child involves a complete head-to-toe exam. The assessment begins with assessing the general state to note the child’s hygiene and grooming and any signs of neglect or abuse (Srinath et al., 2019). The second step is taking vital signs, but different blood pressure cuffs are used based on the child’s age. Anthropometric measurements are taken to assess nutritional status (Srinath et al., 2019). The head-to-toe exam is performed using the four techniques of inspection, palpation, percussion, and auscultation. Special screenings are performed, including Vision, Hearing, and Dental screening (Srinath et al., 2019). The vision screening is conducted using a Snellen’s chart to measure visual acuity. It also involves assessing for squint, strabismus, and nystagmus (Srinath et al., 2019). A hearing screening is conducted if the child presents with complaints of impaired hearing. In addition, a dental screening is done for all school-aged children to assess for common dental conditions such as tooth cavities and bleeding gums as well as shedding of primary teeth and eruption of secondary teeth.
The school-aged child’s physical assessment would be modified to correspond to the age and developmental stage by beginning with the least discomforting or painful procedures and concluding with the discomforting ones (Srinath et al., 2019). I would also assess the parts associated with the chief complaint last. For example, in a child presenting with abdominal pain, I will examine the abdomen last to foster cooperation. Besides, for children from 6-8 years, I will conduct the exam in the caregiver’s presence to ensure cooperation (Srinath et al., 2019). However, for the older child, above eight years, I will provide privacy and promote autonomy. Furthermore, I will provide privacy for the older child by uncovering only the body parts being assessed to avoid discomfort from the development of secondary sexual characteristics.
Typical Developmental Stages of 6-Year-Olds
Key physical developmental milestones include improved locomotor skills such as skipping, running, and jumping. The child should demonstrate strong hand-eye coordination, such as the ability to throw a ball at a target (Scharf et al., 2016). They begin losing the milk teeth, and permanent molars, medial and lateral incisors begin to erupt. Emotional development milestones include demonstrating self-control skills and maintaining emotional stability (Scharf et al., 2016). Cognitive developmental milestones include knowing their age, concept of time, particularly night, morning, and afternoon (Scharf et al., 2016). Most have about 2560 words and make comprehensible 6-7 word sentences. Besides, the child should associate words with their use (Scharf et al., 2016). Typical social developmental milestones include fear of the dark and big animals, sibling jealousy, exhibiting a sense of humor, and being peer-oriented.
Application of Erickson Theory in Developmental Assessment
A 6-year-old falls in the Industry versus Inferiority stage in the Erickson theory. In the Industry versus Inferiority stage, the child develops a sense of confidence by mastering tasks (Orenstein & Lewis, 2020). However, the sense of accomplishment can be offset by a sense of inferiority that arises from failing. I would apply the Erickson theory by assessing a child’s ability to perform tasks independently, such as homework and hygiene and grooming activities, and the ability to regulate social behavior (Orenstein & Lewis, 2020). Besides, I would give the child a task and ask them to do it independently. I would also assess whether the child develops a sense of inferiority, such as low self-esteem, when unable to perform the task.
I would offer explanations using simple and short sentences and inform the child of any painful procedures, to gain cooperation. I would also use polite, non-threatening language to relieve anxiety and promote cooperation (Srinath et al., 2019). Besides, I would ask the child to provide his demographic information and history of present illness to encourage a sense of autonomy. I would also inform the child of the assessment findings, any abnormalities found, and additional tests that will be required.
Growth and development are continuous from conception to death. The physical assessment of a school-aged child involves taking vital signs, anthropometric measurements, head-to-toe exam, visual, hearing, and dental screening. Assessment can be modified by beginning with the least painful procedures and assessing the systems associated with the complaints last. Developmental assessment of a 6-year-old entails assessing milestones in the motor, cognitive, emotional, and social aspects. The Erickson developmental theory can be applied to assess a child’s development by asking the school-aged child to independently perform a task and assess if they develop a sense of inferiority if they fail.
Orenstein, G. A., & Lewis, L. (2020). Erikson’s Stages of Psychosocial Development. In StatPearls [Internet]. StatPearls Publishing.
Scharf, R. J., Scharf, G. J., & Stroustrup, A. (2016). Developmental Milestones. Pediatrics in review, 37(1), 25. https://doi.org/10.1542/pir.2014-0103
Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for the assessment of children and adolescents. Indian journal of psychiatry, 61(Suppl 2), 158. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18
The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:
- Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.
- Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
- Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.
You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.
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Assessment is an important practice in nursing. Assessment provides data that nurses utilize in making their diagnoses and appropriate treatment plans for their patients. Assessment methods differ significantly based on the age group of a client. For example, it is anticipated that the physical assessment methods used for a pediatric patient differs significantly from that of an adult patient. Similarly, the assessment tools utilized to determine the care needs of the patients of different ages vary. Therefore, this paper explores the comparison of physical assessments used in school-aged children, their modification, and assessment of a child based on Piaget’s theory of development.
Comparison of Physical Assessment Among School-Aged Children
The assessment of school-aged children differs significantly from that of the toddlers, infants and the preschoolers. School-aged children have an enhanced understanding of the reality unlike infants, preschoolers, and toddlers that live in a world of fantasy. The thinking also differs among them as seen from the fact that school-aged children have developed logical thinking and comprehension of events. They also understand the consequences of their actions. School-aged children also have developed social skills from interacting with others in their societies. As a result, they have curiosity to learn new aspects in their lives and accomplish tasks for recognition. The children at the age group of 5-12 years can also express their health problems as well as their experience with them (Chiocca, 2019). Therefore, the appropriate modification of physical assessment techniques when working with them entails asking the children appropriate questions. It also entails involving the guardians or parents in the assessment process to obtain adequate data to inform the treatment plans. An additional modification entails beginning the assessment with areas that the children have a high level of awareness and moving to complex aspects of care (Tagher & Knapp, 2019).
Typical Assessment for a Child of a Specific Age
The selected case study involved a seven-year-old female patient brought to the clinic by her parents for assessment. The patient was brought for the annual normal checkup. She was born through caesarian surgery and with an Apgar score of 10. The immunization history is up-to-date with developments appropriate for her age. She does not have any history of surgeries or hospitalizations. The patient should demonstrate a number of cognitive, social, emotional and motor developmental milestones. She should have developed the desired cognitive abilities, as evidenced by her ability to describe her thoughts, feelings, and experiences and appreciate those of others. Further, she should be independent in forming friends and seeks acceptance from others. Finally, she should be able to perform physical activities such as sports and coordinate body activities effectively.
Developmental Assessment of a Child Using a Developmental Theory (Piaget)
Piaget’s theory of development can be applied in the above case study. According to Piaget, child’s development occurs gradually in four stages. The stages include sensory motor (birth to 2 years), preoperational (1.5-7 years), concrete operational (7-11 years), and formal operational (12-19 years). Based on the above, the child in the case study is in the concrete operational stage in Piaget’s model. Children in this stage are expected to have developed logical thinking. They have operational thought process characterized by their ability to relate abstract concepts with their experiences (Chiocca, 2019). Children in this stage also have the ability to express their feelings, emotions, and experiences. They also acknowledge the feelings and emotions of others. The focus of physical assessment when providing care to this client entails asking specific questions that they can answer to the best of their abilities and not her parents. The assessment should also focus on the exploration of issues relevant to the interests of the child. An example is asking questions related to the school, friends, her likes and dislikes. The nurse should provide information in simple language that is easy to understand for the children (Hockenberry et al., 2021). Since the visit by the client to the hospital was for regular assessment, it is anticipated that normal findings will be obtained.
The physical assessment of pediatric patients utilizes different approaches. The assessment depends largely on the developmental stage of the children. Nurses should demonstrate adaptability by being able to change the physical assessment approaches to suit the age group of their patients. In addition, theories of development such as Piaget’s should be used to inform the assessment findings.
Chiocca, E. M. (2019). Advanced Pediatric Assessment. New York, NY: Springer Publishing Company.
Hockenberry, M. J., Wilson, D., & Rodgers, C. C. (2021). Wong’s Essentials of Pediatric Nursing. Los Angeles, CA: Elsevier Health Sciences.
Tagher, G., & Knapp, L. (2019). Pediatric Nursing: A Case-Based Approach. Philadelphia, PA: Wolters Kluwer Health.
Hello Tanya, this is absolutely amazing , in addition during the assessment of a child, nurses should consider the following approaches to offer instructions, adapt communication, and encourage engagement:
Simplify language: Use age-appropriate vocabulary and simple explanations to ensure the child understands the instructions. Avoid medical jargon and provide visual aids or demonstrations when necessary.
Involve the child and parent: Encourage the child’s participation by allowing them to help in simple tasks, such as holding the stethoscope or assisting with measurements. Engage parents by explaining the assessment process and encouraging their presence for reassurance and support.
Use play or distraction techniques: Incorporate play or distraction techniques to alleviate anxiety and make the assessment process more enjoyable. For example, using a toy or singing a song while performing an examination can help divert the child’s attention.
Provide praise and positive reinforcement: Offer praise and positive reinforcement throughout the assessment to motivate and build trust with the child. Recognize their cooperation and provide rewards or stickers for their active involvement.
Assess readiness and adjust pace: Assess the child’s comfort level and readiness for each step of the examination. If the child appears anxious or distressed, take breaks or modify the sequence to accommodate their needs.
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