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Is the child usually withdrawn when around family members?

Is the child usually withdrawn when around family members?

Is the child usually withdrawn when around family members?
Assignment: Case Study on Child Development

Physical: No red flags in the physical development were noted in the case scenario.

Social: Tantrums and failing to keep calm after being comforted by the mother.

Cognitive: Child knows less than 200 vocabulary words and lacks steady vocabulary. Inability to speak sentences of at least 3-words.

Additional Questions

Social: To assess social development problems, I will ask: Is the child usually withdrawn when around family members? Does the child interact with his agemates? Is he interested in simple children stories? Does Brian cry when you get separated from him? Does he have sleeping difficulties?

Cognitive: To identify other cognitive issues, I will ask the mother thus: Does he refer to himself by name? Does he know his sex? Does he understand family name categories like mum, aunt, and baby? Does Brian easily forget usual routines? Does he know common body parts? Is he able to name familiar items like toy, and cup?

Additional Exam: I will conduct a physical exam to assess height, which ranges from 33 -37 inches.

Weight measurement to assess for under/over nutrition, the average weight should range from 24-35 pounds (Ghassabian et al., 2016).

Vital signs: I will monitor the temperature, pulse, and respiration to rule out the presence of fever or respiratory infections. The pulse range of a 0 month-old is 80-130, and the respiration is 20-0 breaths/min.

Head and chest circumference: The chest circumference should exceed the head circumference. The head circumference should range from 18.9-20.9 inches.

Teething: Inspection of teeth eruption which should be about 20 teeth at 30 months.

Testicles: I will palpate the scrotum to assess whether both testes have descended.

Differentiation between Normal and Abnormal Growth and Development for the Patient

Physical: Normal observable physical development in a child aged 2-3 years include: climbing, running, jumping with both feet (Ghassabian et al., 2016). In addition, a child can jump from or step on a chair, build a tower of 9 or 10 cubes, and walking up and downstairs with one foot per step. The child has a normal physical development since he can walk independently, run and climb stairs while alternating the feet, makes a tower of nine cubes, and can button.

Cognitive: At 30 months, a child should be able to make understandable three-word phrases, make real sentences with the use of prepositions and function words though with rhythmic disturbances (Anderson & Burnett, 2017). Besides, the child refers to self as II, points to objects described, articulates words correctly, and has a vocabulary of between 270- 800 words (Bridges, 2017). I identified being able to follow one-step commands as normal but he can only make a one-word sentence, and having a vocabulary of roughly six words is abnormal.

Social: At 2-3 years, a child begins to look for ways on how to regulate emotions and express them. Temper tantrums are frequent in

Assignment Case Study on Child Development
Assignment Case Study on Child Development

children between 1-4 years as the child tries to achieve autonomy and master the environment (Bridges, 2017). Separation anxiety starts to diminish at this stage, but the child may develop a fear of the dark. Refusal to eat is also common in toddlers as they strive to attain autonomy, especially if the caregiver forces the child to eat or dislikes the food (Anderson & Burnett, 2017). In this case, I identified tantrums, resistant to nighttime and feeding routines, as normal but failing to keep calm despite being comforted as abnormal.

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Standardized Screening Tools to Assess the Patient

In this case, I will administer a screening tool to be filled by the mother, and I will also fill one professional tool. The Early Child Development Inventory (ECDI) is a tool that is filled by the parent for a child between 18-36 months and contains 60 items that have yes and no choices that are filled within 10minutes (Anderson & Burnett, 2017). So, I will use the ECDI since it aids in measuring a child’s development in five major aspects, namely, gross, fine, language, comprehension, and social. The Birth to Three Assessment and Intervention System, (BTAIS), screening tool will be filled by the nurse to test for developmental disabilities (Harrison & Oakland, 2015). It contains 85 items that help in identifying difficulties in motor development, nonverbal thinking, language comprehension and expression, and social development in children between 0-3 years.

Clinical Guidelines and Management Strategies

Remediation therapy: The program will involve training the child to make accurate links between letters and sounds (Ghassabian et al., 2016). When he masters the skill, more complex components of reading will be targeted such as pronouncing syllables and words.

Psychotherapy: Emotional and behavioral problems such as tantrums will be managed through social skills training to learn how to interact with other persons (Bridges, 2017).

Parental counseling: The parent will be advised to distract the child to other less frustrating activities when he is having tantrums and reward positive response. Further, the counselling will be used to present alternatives within the child’s abilities so that he can achieve autonomy and also provide the child with food that is presentable and that the child prefers (Bridges, 2017).

Health Promotion and Anticipatory Guidelines: At 30 months, the child should be vaccinated with BCG, inactivated polio 1-3, pneumococcal 1-3, Pentavalent 1-3, Rotavirus 1-2, MMR 1, Hepatitis A 1-2 and Influenza 1-2. The next set of immunization include Influenza annually and inactivated polio and MMR at four years (Robinson, Bernstein, Romero & Szilagyi, 2019). At three years, the child will be immunized with Influenza vaccine. The next well child clinic will be after six months. The mother will be advised to bring the child for medical attention if he develops fever, seizures, convulsions, or difficulty in breathing.

You see a 30-month-old named Brian for a well-child visit. His mother reports the following development:
• Physical: Walks independently, runs, able to climb stairs alternating feet, makes a tower of nine cubes, and is able to button his pants.
• Social: Follows one-step commands, uses one-word sentences, and has a vocabulary of approximately six words. He is resistant to nighttime and feeding routines, he has marked temper tantrums, and Mom states he does not calm when she tries to comfort him.

Post an explanation of the following:
1. Developmental red flags that presented on the stages of normal physical, social, and cognitive development for infants, toddlers, and preschoolers. Based on the red flags identified within the physical, social, and cognitive what additional questions should you ask? What additional examinations will you conduct?
2. Explain how you differentiated between normal and abnormal growth and development for this patient.
3. Identify which standardized screening tools, clinical guidelines, and management strategies you might use to assess and manage this patient and why.
4. Health, promotion and anticipatory guidance:
1. Based on the child’s age, discuss which immunizations this child should have received by now?
2. When are the next set of immunizations? Which ones should be given?
3. When should this child return to clinic?

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