Biological functioning and well-being of pediatric populations
After completing your research, respond to the following questions:
Why is developmental assessment essential in the provision of primary care for infants, children, and adolescents, and what are the essential components of this assessment on the basis of a child’s age?
Which tools will you use to assess specific components of development (such as speech, motor skills, social skills, etc.)? Which tools do you think are the most accurate in assessing the developmental components and why?
Which components would you consider in assessing the basic biological functioning and well-being of your pediatric patients? Why are these components important in providing primary health-care services to children?
This week, you will focus on child development. You will learn about various tools used for developmental assessment and to apply them to pediatric patients based upon their age and stage of development.
This has been a very information-dense week. You learned about various factors and tools that need to be considered while assessing child development, from birth through adolescence.
Let’s look at the various developmental stages that a child goes through and understand how prenatal and environmental factors impact child development at each stage. As a nurse practitioner, you must track development to effectively provide primary care.
The first few months of infancy involve neurobiological adaptation to extrauterine life. The infant is no longer “plugged in” to a constant source of nutrition and oxygen (hemoglobin-delivering oxygen). This adaptation is dependent upon the infant’s environment, temperament, and parental responsiveness to infant cues. Primitive reflexes are a reflection of neurobiological responses to stimuli. These reflexes should be extinct by six months of age. If they are not, this is a red flag for referral. The Bayley Infant Neurodevelopmental Screener (BINS) can be used to identify developmentally delayed infants and infants with neurological deficits. Clinicians using this tool must have specific training and credentials (Ringwalt, 2008).
Toddlerhood is a time when a child begins to socialize, acquires language, and makes attempts to test his or her environment, which overshadows nutrition. This stage is not a time of rapid growth as is also evident from the growth charts. During this stage, clinicians should implement the Modified Checklist for Autism in Toddlers (M-CHAT) for toddlers (sixteen to thirty months) (Robins, Fein, & Barton, 1999). This tool has twenty-three items from the autism spectrum that provide a measure of the potential findings of autism. If the child fails two or more critical items or any three items, then he or she should be referred to an autism specialist (Robins, Fein, Barton, & Green, 2001).
The preschool-aged child is being further introduced into society. Clinicians should focus on the fine motor skills and social and language skills. The Early Screening Inventory-Revised (ESI-R) is a tool that has a norm-referenced scale (validated and reliable) to identify children who may need special education services. The tool addresses various developmental areas that include visual skills, motor or adaptive skills, language and cognition, and gross motor skills. It assists in identifying learning blocks, school preparedness, developmental delays, and learning problems in children aged three to six years (Ringwalt, 2008). The tool involves parental involvement and requires about fifteen to twenty minutes to answer the questionnaire. Click here to learn more about the tool.
In school-aged children, socialization and learning become the primary focus of the developmental assessment. As children get older, use of preadolescence behavioral screening tools and mental health screening tools becomes more important. This is a time when parents may become concerned about attention-deficit and behavioral disorders in children that impact their success in school. The Pediatric Symptom Checklist (PSC) is a tool that assists in identifying psychosocial dysfunction in children four to sixteen years of age (Ringwalt, 2008). This tool is useful in identifying cognitive, emotional, and behavioral problems in school-aged children through adolescence. Click here to learn more about the tool.
Adolescence is a time of increasing independence and self-realization or identity development. During a well-check visit, this is a time to be on sentinel for high-risk abusive behaviors.
The CRAFFT* tool is a behavioral screening tool that addresses high-risk alcohol and drug use behaviors.
The HEADSS** assessment involves the social factors that impact adolescent development. Click here to learn more about this assessment.
You should explore the various tools used in your clinical setting and understand the intended use, reliability, and validity of these tools.
C: Have you ever ridden in a “Car” driven by someone (including yourself) who was “high” or had been using alcohol or drugs?
R: Do you ever use alcohol or drugs to “Relax,” feel better about yourself, or fit in?
A: Do you ever use alcohol or drugs while you are by yourself, “Alone”?
F: Do you ever “Forget” things you did while using alcohol or drugs?
F: Do your family or “Friends” ever tell you that you should cut down on your drinking or drug use?
T: Have you gotten into “Trouble” while you were using alcohol or drugs?
(Two or more “yes” answers suggest a significant problem.)
E: Education and employment