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Pediatric

Pediatric

Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.

KN Discussion:

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 this child’s age?

Developmental assessment is crucial in monitoring a child’s performance in in several evaluated areas, like physical, emotional, neurological, and psychosocial development. It is routinely performed at each well – child visit and may be done additionally if there is a concern. According to American Academy of Pediatrics (AAP) and CDC (2021), developmental screenings should be completed at least at 9 months, 18 months, and 24 or 30 months. During infancy kids develop at rapid speed at it is vital to catch any type of delay and initiate early intervention if needed (Vitrikas et al., 2017). In fact, developmental assessment changes as children grow, and parameters evaluated in infants will be totally different from those evaluated in school age kids, toddlers, and adolescents (Stoppler, 2018). Primary care providers are responsible for careful monitoring of child development and identification of any kind of deficits, as well as, timely addressing it (Stoppler, 2018).  It may be hard for families to understand the situation and accept help; yet, the education and proper referral is another essential task for a healthcare provider. According to CDC (2021), AAP recommends assessing the following areas of performance in pediatric patients as developmental screening:

  • Motor development
  • Cognitive development
  • Language development and communication
  • Social and emotional development, as well as mental health screening.

Besides, each healthcare provider should implement the following into practice routine (CDC, 2021):

  • Monitor development of the child at every visit.
  • Use reliable and valid screening tool for scheduled screenings.
  • Refer for additional evaluation and complete more comprehensive assessment if a concern is identified.

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?

There is an abundance of valid screening tools that can be used by healthcare providers for developmental assessment. As mentioned above, first years and even more months of human life are crucially important for development and utilizing a valid screening tool may aid in early recognition and timely intervention if there are any deficits (Vitrikas et al., 2017). The areas of child’s development being routinely assessed are social/emotional behavior, vision and hearing, gross and fine motor skills and coordination, cognitive abilities, speech and language (Stoppler, 2018). Parents are the main source of information during early stages of life. It is vital to make sure they understand the purpose of developmental screening and are willing to collaborate. Gross and fine motor skills may be assessed by a standardized screening tool Ages & Stages Questionnaire (ASQ) (Vitrikas et al., 2017). A provider may observe the key elements like walking, sitting, coordination, fine motor skills during the visit and also ask pertinent questions to parents (Stoppler, 2018). Language assessment is an important part of each child’s development and is proven to affect learning abilities and pattern of learning. In early stages the assessment is greatly dependable on the children’s caregivers (Vitrikas et al., 2017). A standardized tool, like Early Language Milestone (ELM) could be used to evaluate child’s language development (Vitrikas et al., 2017).  A provider should ask about vocabulary, attempts to mimic sounds, communication abilities, as some children are not willing to perform during the visit (Stoppler, 2018). Physical exam may reveal some abnormalities that interfere with normal speech development; thus, assessment of oral structures should be taken seriously (Stoppler, 2018). As pertains to growth and weight gain monitoring a growth chart may be used (AAP, 2019). It consists of a series of percentile curves that illustrate the distribution of selected body measurements in children (CDC, 2021).

Overall, the at ASQ is a reliable, affordable, and easy to use screening tool.

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?

Multiple factors may influence the development and wellbeing of the child. This begins from preconception care and parental genetics and sometimes abnormalities are going to be present despite the high level of care and prevention measures (Vitrikas et al., 2017).  Nutrition and environmental factors are also vital for proper growth and development. Therefore, during each visit a healthcare provider should assess the child and educate the parent on what to expect from the next stage of development (Stoppler, 2018).  Following are the main components of physical assessment (Stoppler, 2018):

  • head circumference
  • weight
  • height
  • temperature
  • Heart rate
  • Respiratory rate

Besides, the skin, abdomen, oral cavity, head, neurological development, as well as vision, hearing, cognitive abilities, and mental state should be assessed during the visit (AAP, 2019).   According to guidelines, annual well child visit should also include urinalysis and anemia screening (AAP, 2019).

These components are essential to evaluate in assessment of biological functioning and wellbeing baseline criteria.

References

American Academy of Pediatrics: Universal Screening Urged for Developmental Delays. (2019). American Academy of Pediatrics. https://www.healthychildren.org/English/news/Pages/Identifying-Developmental-Disorders-Through-Surveillance-and-Screening.aspx

Developmental Monitoring and Screening for Health Professionals. Centers for Disease Control and Prevention. (2021). https://www.cdc.gov/ncbddd/childdevelopment/screening-hcp.html

Factors Affecting Child Development. (n.d.). https://www.beststart.org/OnTrack_English/2-factors.html#biological

Sheldrick, R. C., Schlichting, L. E., Berger, B., Clyne, A., Ni, P., Perrin, E. C., & Vivier, P. M. (2019). Establishing new norms for developmental milestones. Pediatrics, 144(6).

Stoppler, M. (2018). Developmental Screening – Critical for Every Child. https://www.medicinenet.com/developmental_screening_-_critical_for_every_child/views.htm

Vitrikas, K., Savard, D., & Bucaj, M. (2017). Developmental delay: when and how to screen. American family physician, 96(1), 36-43.


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