Consequently, the physical assessment of children requires the use of varying techniques that depend on the child’s age and developmental stage. For example, an important part of the physical assessment is collecting health history. To collect the health history of a 5-year-old child, the nurse will have to get a large portion of information from the child’s parents. The technique will be modified for a 12-year-old child, who will be expected to answer most of the questions himself. Furthermore, children aged 12 years become more conscious of their bodies than those aged five years (Burke, 2020b). It also influences the choice of physical assessment techniques since 12-year-old children may require privacy when changing their clothes and want their parents to be absent while they undergo a physical examination. Thus, during the physical assessment, children’s developmental stages and age-specific needs should be considered.
Children go through typical developmental stages, which will be explained by the example of Jared, a 12-year-old boy. Jared was born at 37 weeks, weighing 3.2 kg, and doubled his birth weight by six months. At four months, he was able to hold his head in a vertical position and grasp objects. By nine months, he was able to crawl, and when he was one year old, he started to walk. At the age of 2-3 years, Jared learned to tolerate separation from his parents, which allowed them to take him to a day-care center, where he enjoyed playing with toys and participative in imitative play. At the age of five, he could speak using simple but complete sentences and developed fine motor skills enabling him to use scissors and tie shoes. When Jared was six years old, he lost his first deciduous tooth. At school, he made friends with same-sex children, which is common among school-aged children (Burke, 2020a). At the age of 12, Jared began experiencing the signs of the onset of puberty, which included mood swings and a slight voice deepening.
Various developmental theories have been constructed to explain the changes occurring in children over time and guide their developmental assessment. Jean Piaget distinguished four stages of children’s cognitive development: sensorimotor, preoperational, concrete operational, and formal operational (Gilmer & Chiplis, n.d.). School-aged children belong to the preoperational stage until they are seven years old and then transit to the concrete operational stage that lasts up to the age of 11 years. Since Jared is already 12 years old, he is likely to enter the formal operational stage of development, at which children develop the ability to think and reason in abstract terms and understand hypothetical situations (Gilmer & Chiplis, n.d.). Therefore, to perform this child’s developmental assessment, it is necessary to focus on his ability to operate abstract notions and hypothetical situations.
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To offer explanations to the child during the assessment, the assessor should communicate with him as if he were an adult. The reason for this is that, by the age of 12, children develop a good command of their language and have a complete vocabulary (Burke, 2020a). Furthermore, treating a 12-year-old child in a non-childish way will help to gain cooperation because children of that age begin to question the authority of adults, including health providers (Burke, 2020a). The child should be asked if he wants his parents to be present at the assessment, and the majority of questions should be addressed to the child rather than parents. Potential findings from the assessment include the child’s ability to relate his thoughts using a good command of the language, the desire to communicate and identify with peers, and the ability to think abstractly. The first signs of puberty may also be noticed, and the child may express concerns about the changes occurring to his body.
To sum up, the age and developmental stages are significant factors that should be considered when choosing appropriate techniques for the physical assessment of children. These factors help to determine developmental milestones that define what is expected of a child at a particular age. If the child fails to reach the milestone, it is a sign for healthcare providers to adjust care to meet the needs of this child. Developmental assessment of children can be guided by various theories. One of them is Piaget’s theory of cognitive development, which establishes milestones in children’s development of cognitive abilities.
Burke, A. (2020a). Aging process: NCLEX-RN
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