Nurs 6541: Primary Care of Adolescents and Children Week 2 Developmental Red Flags

Nurs 6541: Primary Care of Adolescents and Children Week 2 Developmental Red Flags

Nurs 6541: Primary Care of Adolescents and Children

Week 2 Developmental Red Flags

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Initial Post

Case Study 3

Jose is a 36-month-old who presents for a preschool evaluation. His father reports the following development:

  • Physical: Walks, runs, and jumps independently, walks upstairs alternating feet, pedals a three-wheeler, scribbles, copies circles and squares, and is able to balance on one foot for 2 to 3 seconds.
  • Social: Recognizes three colors; speech is 75% understandable; uses three- to four-word sentences; talks about friends, favorite activities, and family; frequently engages in imitative play; has an imaginary friend; does stutter on occasion when excited or when intent on getting something said. Will typically repeat the first word in a sentence three to four times, but does not repeat syllables or consonants. This happens three to four times a week. Nurs 6541: Primary Care of Adolescents and Children Week 2 Developmental Red Flags

 

During the collection of information for the history, the provider will require the father to complete a previsit questionnaire supplied by Bright Futures Tools and Resources Kit for the three year visit to assist with provider with assessing if the child is meeting developmental milestones (Hagan, Shaw, & Duncan, 2017).  Another option is to have the father complete a Parents’ Evaluation of Developmental Status that has ten items that will take the father 2 to 5 minutes to complete and is available a variety of languages (Mackrides & Pyherd, 2011).

History

Based in the information provided by the father, the child in the case study, meets the gross and fine motor developmental milestones by being able to balance on one foot for 2 to 3 seconds, pedal a tricycle, copies circles and squares, and walk stairs using alternating feet (Burns, Dunn, Brady, Starr, Blosser, & Garzon, 2017). The child is meeting the language milestones by being able to speak in 75% understandable to strangers and uses three word sentences (Hagan et al., 2017). Social milestones that are meet include engaging in imaginary play and discusses items such as activities and friends (Hagan et al, 2017). The word repetition of words such as those at the beginning of a sentence described by the father is normal for this age group when the child is excited or expressing an important message (Burns et al., 2017). Nurs 6541: Primary Care of Adolescents and Children Week 2 Developmental Red Flags

 

The father did not state if the child is able to use the restroom independently, dress themselves, feed themselves, or place in cooperation with other and share (Hagan et al, 2017).  Language skills that were not addressed are if the child is able to tell a story from a book or television, compare things such as boy or girl, big or short, or repeat numbers (Hagan et al, 2017). Some of the fine motor skills that were not expressed include drawing a person with head and one body part and cut with child proof scissors (Hagan et al., 2017).

Assessment/Intervention

During the assessment, the child’s hearing and vision is assessed to ensure that there are no physical issues that may cause a delay in development. Mouth and neurological systems are assessed to address any health or comorbidities early to apply interventions such as a referral to neurologist, speech pathologist, or ophthalmologist if required. Some red flags would include if the child is unable to understand prepositions, action words, or follow two step directions would indicate receptive language delay (McLaughlin, 2011).  An expressive delay is indicated if the child is unable to use at least 200 words, ask for things by name, or repeats phrases in response to questions (McLaughlin, 2011). None of the above items were expressed by the father regarding the child. Education is provided to the father regarding the developmental milestones the child should meet by 3 and 4 years of age. Initiating the conversation and educational process regarding developmental milestones early will assist the parents with identifying a potential problem (Burns et al., 2017). Educational material search as Hawaii Early Learning Program at Home (HELP) information to assist with activities at home the parents can do to assist with child with meeting the milestones and arranging additional office visit to assess the child progression and assess if additional intervention is required (Burns et al., 2017). Nurs 6541: Primary Care of Adolescents and Children Week 2 Developmental Red Flags

References

Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L.  (Eds.).

(2017). Pediatric primary care (6th ed.). St. Louis, Missouri: Elsevier.

Hagan, J. F., Jr., Shaw, J. S., Duncan, P. M. (Eds.). (2017). Bright futures: Guidelines for health

supervision of infants, children, and adolescents (4th ed.). Elk Grove Village, IL: American Academy of Pediatrics.

Mackrides, P.S.,& Ryherd, S.J.(2011). Screening for Development Delay. American Family

Physician. 2011 Sep 1;84(5):544-549.

McLaughlin, M.R. (2011). Speech and Language Delay in Children. American Family

Physician. 2011 May 15;83(10):1183-1188. Nurs 6541: Primary Care of Adolescents and Children Week 2 Developmental Red Flags

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