Introduction
The assessment of school-aged children is a vital part of preventive healthcare. The process of monitoring young patients’ progress through the developmental changes allows clinicians to see whether children are meeting their age-related milestones and if there are any signs of developmental issues that can be addressed promptly. Patients’ lifestyle choices, interests, and levels of independence have to be addressed in combination with physical assessments.
Physical Assessments
In comparison to younger patients, school-aged children have not only an increased desire to perform tasks themselves but also a sense of modesty. Moreover, as they become conscious of their bodies, they may need privacy or a special gown (Riley, Locke, & Skye, 2011). The patient may have a preference of asking parents to leave or stay with them during the assessment. Thus, a nurse has to ask the child and adhere to their answer to establish trust and make the patient comfortable. The overview of the system during a physical examination at this age is performed in a head-to-toe manner. Children may be inquisitive about the procedures, and an explanation of all steps with simple words may keep the child cooperative and engaged.
As children become interested in their bodies during this age, it is an opportunity for a health provider to teach them about different functions of the body. In older school-age children, the assessment of genitalia may be appropriate if it is necessary. Otherwise, all types of physical examinations are needed to complete the appointment, including head, eyes, ears, nose, mouth and teeth, neck, respiratory and cardiovascular systems, abdomen, musculoskeletal and neurological systems, and skin (Riley et al., 2011). Moreover, nutrition, safety, health promotion, and family situation have to be addressed. Older children prefer a more straightforward approach – thus, their examination has to be open and include the child in the discussion.
Typical Developmental Stages
At ten years old, children learn to perform challenging tasks that require significant concentration. Their motor skills allow them to participate in team sports and ride bicycles. Puberty may start for some children, especially girls – it begins with the development of breasts and changes in the body or facial shape. Body planning becomes a norm – children learn how to put their bodies in a comfortable position (“Developmental milestones,” 2017). In regards to language and communication, their speech becomes more complex as they form long sentences, but they still do not show a deep understanding of topics (“Developmental milestones,” 2017). Social interactions become increasingly important, and some sexual interest in peers may occur.
Erikson’s approach to assessing children’s development relies on their emotional maturity and the influence of outside forces. According to Erikson’s eight stages of emotional development, children from 5 to 12 go through such stages as “Purpose: Initiative vs. Guilt” and “Competence: Industry vs. Inferiority” (Knight, 2017, p. 1051). At the first stage, children start learning the principles of the world as well as basic skills. Here, the child needs to learn about guilt and initiative, supporting children’s independence. The clinician may gain trust by offering simple explanations. The second stage challenges children’s self-confidence and leads to the development of personal interests. A conversation about school and extracurriculars is a way to increase cooperation, as well as the inclusion of the patient into the treatment process.
Conclusion
School-aged children enter a challenging period as they gain more responsibilities and pressures while also acquiring a personal view of the world. They become cooperative with the clinician during the assessment, and their behavior indicates the development of modesty and desire for independence. From 5 to 2 years, children learn to plan their movements and start being interested in their bodies. Erikson’s theory suggests that young school-age children have to be treated as individuals, listening to their opinions, and being open to gain their trust.
References
Developmental milestones. (2017). Web.
Knight, Z. G. (2017). A proposed model of psychodynamic psychotherapy linked to Erik Erikson’s eight stages of psychosocial development. Clinical Psychology & Psychotherapy, 24(5), 1047-1058.
Riley, M., Locke, A. B., & Skye, E. P. (2011). Health maintenance in school-aged children: Part I. History, physical examination, screening, and immunizations. American Family Physician, 83(6), 683-688.