Providing Developmentally Appropriate Care to Pediatric Patients

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Providing Developmentally Appropriate Care to
Pediatric Patients 

• Your name, institution, date etc.

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Introduction

• State the purpose of the discussion
• Identify yourself

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Topics of Discussion

• Developmental Stages
• Child Friendly Interactions
• Language Issues
• Area Specific Procedures
• Child Life Specialists and Preparation

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Developmental Stages

• Infants (0-12 months)
• Toddlers (1-2 years)
• Pre-schoolers (2-5 years)
• School Aged Children (6-10 years)
• Adolescents (11-18 years)

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Infants (0-12 months)

• Physical
• Totally dependent on adults to meet their needs
• Learning/Psychological
• Learn by use of their senses and through activity
• Enjoys play with people and objects

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Infants (0-12 months)

• Psycho-social
• Recognizes familiar faces
• Uses crying, body language, and tone of voice to
  convey wants/needs
• Derives pleasure
• Feeding situations
• Being held or rocked
• Tactile stimulation

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Infants (0-12 months)

• Fears
• Greatest fear is the fear of separation from
  caregiver
• After age 6 months, infants are afraid of
  strangers

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Toddlers (1-2 years)

• Physical
• Developing control of body (i.e. walking, toilet
  training)
• Psycho-social
• Increasing independence
• Enjoys exploring environment in the presence of
  the primary caregiver
• Stranger anxiety can be great in some toddlers

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Toddlers (1-2 years)

• Learning/psychological
• Developing a sense of object permanence
• Beginning sense of time
• Magical thinking
• Short attention span
• Follows simple directions
• Increasing vocabulary

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Toddlers (1-2 years)

• Fears
• Separation
• Loss of control
• Pain
• Altered rituals
• Beginning to relate cause and effect, but no real
  concept of fear

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Preschoolers (3-5 years)

• Physical
• Increasing fine motor skills
• Gross motor skills becoming more coordinated

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Preschoolers (3-5 years)

• Psycho-social
• Intense need for caregiver when under stress
• Initiates activities rather than just imitating
  others
• Developing social behavior
• Greater autonomy and independence
• Likes dramatic and imaginative play

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Preschoolers (3-5 years)

• Learning/Psychological
• Ego-centric view experiences from own
  perspective
• Increasing vocabulary and clearness of speech
• No logical or abstract thought
• Difficulty distinguishing between reality and
  fantasy

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Preschoolers (3-5 years)

• Fears
• Mutilation
• Loss of control
• Death
• The dark
• May see illness/injury as punishment for bad
  behavior (still egocentric)

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School-age Children (6-10 years)

• Physical
• Increasing fine motor skills
• Psycho-social
• Still needs caregiver in times of stress
• May be unwilling to ask for help
• Successes contribute to positive self-esteem and
  self-control
• Establishing same sex peer groups

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School-age Children (6-10 years)

• Learning/Psychological
• Age of accomplishment
• Increasing competence and mastery of new skills
• Beginning of logical thought
• Deductive reasoning develops
• Interested in learning about body functions
• Interprets phrase and idioms at face value

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School-age Children (6-10 years)

• Fears
• Separation from friends
• Loss of control
• Physical disability

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Adolescents (11-18 years)

• Physical
• Developing mature sexual orientation
• Psycho-social
• Transition from childhood to adulthood
• Quest for independence can lead to family
  dissension
• Acutely aware of body appearance and
  imperfections
• May view illness in terms if change in appearance
  and function
• Peers are important fro psychological support and
  social development

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Adolescents (11-18 years)

• Learning/Psychological
• Can imagine the consequences of actions and
  illness
• Concept of time well developed
• Memory fully developed
• Beginning to think about concepts outside own
  experiences

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Adolescents (11-18 years)

• Fears
• Change in appearance
• Dependency
• Loss of control
• Separation from peers

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Child Friendly Interactions

• Get on the childs level
• Introduce yourself and your role
• Unknown people are threatening
• Only give choices where choices exist
• Do not make promises you cannot keep
• Appearances can be deceiving DONT ASSUME

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Language Issues

• Be careful of medical terms we take for granted
• You do not have to say it hurts
• Do not use the phrases
• Be a big girl/boy
• Big girls/boys dont cry
• Talk to the patient and explain what you are
  doing
• Use descriptive words

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Area Specific Procedures / Real Life

• Give an example or real life anecdote
• Sympathize with the audiences situation if
  appropriate
• Give area specific guidelines/advice
• Take questions about specific situations

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Child Life

• Discuss your role and how you can help
• Let staff know when you available and how to
  contact you
• Discuss possible teaching/preparation tools

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What This Means

• Add a strong statement that summarizes how you
  feel or think about this topic
• Summarize key points you want you audience to
  remember

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Next Steps

• Summarize any actions required of your audience
• Summarize any follow up action items required by
  you

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