Developmental assessments are standard health maintenance procedures in school-aged children. Physical examinations may be common and allow to determine subjective and objective information fundamental to providing care. Physical assessments may be inherently uncomfortable for children, therefore, it is important to utilize appropriate techniques and create a safe environment that is tailored to an individual’s age and level of development.
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In many ways, a physical assessment of a child does not differ from that of adults as it contains many of the same elements such as demographic data and practices, history, health status, vital signs, and a close examination of each system.
However, the approach would differ depending on age. With younger school-aged children it may be appropriate to utilize a playful format, incorporate colorful pictures and posters for demonstration, allow a hands-on approach with some instruments, and be more considerate of physical reactions to inspections such as palpation and percussion. Younger children are less likely to be still and patient, requiring the medical professional to engage them while performing tasks in an efficient manner.
Meanwhile, older children starting at the age of 9-10 tend to demonstrate more maturity, no longer needing the play-style approach. While friendliness is encouraged, older children may value honesty and privacy as some of the aspects during the examination. Older children are more aware of one’s gender, cultural values, and personal space, all of which should be respected and considered during assessments. At all ages, a nurse should attempt to establish rapport with the child and modify communication style based on the mental maturity and development of the patient (Thomas, 2017).
A child at the age of 6 is in the middle childhood development stage. It is considered a transitional period, and many undergo significant physical and emotional changes. On an emotional and mental level, children at this age are demonstrating more independence, self-awareness, and social connection with others while rapidly acquiring mental skills and the ability to clearly express themselves in more complex sentences.
Academic development such as reading, comprehension, and increased attention spans are also part of this development stage (Centers for Disease Control and Prevention, 2019). At age 6, children are more aware of their body, leading to potentially more complaints of aches. Baby teeth begin to be replaced by permanent adult teeth. Kids in middle childhood commonly grow at a rate of 2.5 inches per year and a healthy gain of 4-7 pounds. It is normal for proportions to change as children will see a growth in height, particularly in legs, beginning to resemble adults. Children become physically active, and strength and muscle coordination will improve rapidly but may depend on individual characteristics (Morin, 2019).
A popular theory of development is Kohlberg’s Theory of Moral Development which breaks down the moral growth of an individual into stages. At the age of 6, most children should fulfill level 1 of pre-conventional morality development. It includes the first stage of the obedience and punishment approach where behavior is based on good to avoid negative consequences.
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Following is the second stage of individualism and exchange, with children understanding the pluralism of morality concepts given by different authorities and are motivated by the reward for following the rules. The assessment for Kohlberg’s theory consists of introducing a moral dilemma scenario that presented a conflict of values and asking a child provocative questions. The typical scenario is the Heinz dilemma that attempts to compare the rule of law versus saving another person’s life (Lumen, n.d.).
It is important to create a safe environment during the assessment by explaining it as similar to a discussion or quiz in school. Allow the child to feel comfortable and assure them that they should voice any discomfort. Explanations should be simple and age-appropriate. Engagement should be supported through a hands-on activity, short sessions, and allowing a child to bring a toy with which they feel safe. Findings from the assessment should determine the moral development and health of the child, also highlighting potential mental or social issues that they may be experiencing.
Centers for Disease Control and Prevention. (2019). Middle childhood (6-8 years). Web.
Lumen. (n.d.). Kohlberg’s stages of moral development. Web.
Morin, A. (2019). 6-year-old child development milestones. Web.
Thomas, M. (2017). Nursing assessment. Web.