Development Monitoring And Screening 2-Year Old Child: Report Assessment
Introduction
The developmental monitoring and screening represent powerful techniques which focus on determining the way a child grows and also how he or she changes over the time. In case of children who are diagnosed with a developmental delay, it is essential to find the cause in an early stage in such way that the correct treatment can be offered which will increase the quality of life of the pediatric patient in the upcoming years. The entire process consists of a close examination both at a physical and also psychological level. Because of the importance of these elements, the following paper will present the case of a 2-year-old female who was examined by me.
Parameters presentation and analysis:
The pediatric patient chosen for this assessment has the initials M.G and is a 2-year-old female. She was born in the urban area on 12 January 2016 and during the assessment, she had a weight of 11.9 kilograms (26.25 pounds) and a height of 85 centimeters (33.46 inches). In case the infant would have been under 24 months, the weight for length percentile could have been used which takes into consideration the sex, weight, and length of he or she. Because the children presented in this paper has 2 years and 9 months, these parameters will be analyzed based on the BMI for age percentile which requires the calculator of the body mass index and after that the comparison of that value with a list of given values for the specific gender. Based on the formula BMI = weight/(height)
2 , she has a BMI of 16.5. This puts her at a 72% on the percentile scale which means that she has a healthy weight. If it were to examine the scale we would be able to see that in case of others who have the same age and height as her, the normal weight ranges from a value of 10.1 to 12.4 kilograms.
Based on the Dietary Guidelines for Americans, a child in the situation of the one presented needs around 1,000 calories per day in order to fulfill the body’s needs. This value can suffer changes based on the actual weight of the child and also her activity level. The following represents the diet of M.G. Her mother is carefully monitoring her weight because they had a lot of overweight people in their family because of that, by examining the diet listed below we can state that M.G is indeed undergoing a healthy diet for a child of her age and that explains her good body mass index calculated above. It is generally accepted that milk is an important part of the diet because it provides with a lot of Calcium of Vitamin D which are essential vitamins during the growth process. In case the children refuse to eat dairy products they can be replaced with other calcium sources such as cooked dried beans or green vegetables. This age also represents the period during which the child should get accustomed to an eating timeline. Because of that, it is requested for their parents to try to impose 3 meals per day and also 2 snacks.
Developmental Theories
In terms of developmental theories, the first one this paper will refer to is Erikson's. He maintained the idea that the personality of a person develops in a linear manner and very dependent on the previous stage. This principle is known as being the epigenetic principle and it characterizes this theory of psychosocial development. In the case of Erikson's theory, there are 8 different stages each of them being represented by a specific psychosocial crisis and a basic virtue. Based on this, M.G who is 2 years old first in the second stage which describes the crisis as being autonomy versus shame while the basic virtue is will.
During this period, the child becomes aware of the fact that she is more mobile and starts discovering new abilities. In the case of M.G, it is easy to notice that she developed a sense of autonomy and also independence. She frequently tells her mother what she wants to eat and during my visit, she insisted on what toys she would like to show me. When I tried to give her an alternative game we could play, she immediately declined and insisted we should do it in her way. If she managed to continue this way, it is expected that she will become more secure on her own abilities and will be less dependent on the people who surround her. The second perspective used will be the one based on Piaget's Theory. In this case, the entire theory focuses on finding out the way an infant becomes an individual who is able to think in a hypothetical manner.
Taking into consideration M.G's age would fit between two stages: the sensorimotor and also the preoperational one. During the first one presented, the child usually gets used to the idea of causes and effects and is able to understand what their senses are and also different types of body languages. M.G is able to understand that her mother is angry when she crosses her arms or that her father is upset when he covers his eyes. The second stage refers to being able to use symbols and stimulate the imagination. During our play time, she came up with names for each toy and gave them a role in the game. Overall she is able to understand that what she does can have an effect.
After she broke the vase in the living room while running she understood that she is going to be punished if that action is going to be repeated so she avoided running in the room for the upcoming days and was more careful when passing next to glass objects.
Family
In the same home with M.G lives her mother, her father, and her grandmother. Because her parents work a lot, the girl tends to spend more time with her grandmother who is fully dedicated to raise her. It is generally accepted that parents act as role models for their children and that they tend to imitate their actions in order to look more like them. M.G is definitely the type of child who is pampered by her grandmother, but she is neglected by her parents who are too frequently caught with their job. Because of these situations, she can grow up as being a cold and suspicious teenager and in the same time, she might search for a person to rely on as she is used for others to solve her problems.
Home assessment
During our home inspection, no objects that could bring safety issues were found. The house was designed for a child too and all the toxic chemicals are kept locked up in a box where the little girl doesn't have access. It was obvious to me that the parents invested a lot in customizing their home in such a way that it would be a safe place for their child.
Current level of developmental
Based on the diet M.G is following, it seems obvious that she is receiving the necessary intake of elements for her age. At her age, she is able to run safely as her muscle are becoming stronger and stronger and her equilibrium is better. She is also able to walk up and also down the stairs while holding on. Creativity is definitely an element of interest in her case, as she seems attracted to coloring books. Even though she doesn't know how to color the pages, she keeps on attempting to draw different geometrical shapes. During that moment, I realized that M.G was left handed as she holds her pencils in that end. Furthermore, I was able to see that she was more inclined in using her left hand for diverse activities rather than the right one such as when trying to turn pages from a book.
In terms of social and emotional development, she became more interested in pretending plays with the ones surrounding her which proves that she is more interested in interacting with them. During my analysis, I was also able to see that she started understanding the notion of empathy as she is able to interpret different expressions. When her grandmother cried she immediately started crying too because she interpreted that it is a sad moment and that crying is a way to express it. The only problem is that she is an isolated child. Since her family didn't send her to any baby nursery and because there aren't any neighbors of her age, she might grow up as a shy girl who will need more time to integrate herself in a social group.
Anticipatory Guidance
At the age of two years, the child is passing through a period of transition from infancy to what is known as childhood. She will be able to have a better understanding of symbols, of expressive language and will engage in pretend play as her creativity is boosting.
The parents need to be aware by the fact that during this period the child is passing through a series of emotions which he or she is not familiar with meanwhile they are trying to also understand the others feelings. Because of that and because of their lack of knowledge regarding guild, angel or frustration, temper tantrums are frequent as they represent a way of expressing these things.
It is expected that during this year, the child to be able to use more complex sentences. If at the beginning of year two most of them make up sentences made out of 2 to 3 words, at the beginning of the three years they start using more words and create sentences up to 5 words. They also understand the notion of receiver and transmitter and because of that parents can start having short conversations with them as they will know when it is their turn to speak.
An essential element at this age is the toilet training. Parents need to be aware that the beginning of the second year, the child might be able to start learning how to use the toilet. There are some signs that will indicate that the child is able to do this and they are represented by the desire to do more things without always asking for help, they are more interested in joining the others when they go to the toilet, they announce their parents when they need to go to the toilet and nevertheless they can follow simple instructions. Even so, the parents need to keep in mind that this is a very hard thing for the child to learn and they should not push it. It might take some time until the child fully understands the concept.
Goals
When we refer to outcomes, we are referring to both the desired one for the children and also for the parents. In the case of children, the desired outcome is to be able to develop as a normal person and avoid any injuries or pathologies that could interfere with the growing process during this period of time. They need to be encouraged in such a way that they will stimulate their creativity and also the way they express themselves in order to avoid future psychosocial difficulties. They should be able to integrate themselves into other groups by ensuring that during their time at home they are included in group activities which will stimulate their need to interact with their others.
When we refer to the parents, their ultimate goal is to be able to exhibit parenting skills which are improved. This is done by being able to show a correct parenting behavior which is correlated to the child needs and is able to control it in a difficult situation. On the other hand, it is essential to be able to maintain a safe environment for their children to reduce the risk of injuries and hospitalization.
Nevertheless, they need to be able to establish a productive relationship with their child which will benefit for M.G and also her parents. Nevertheless, they need to be open to accepting support from other peoples when they can't handle a specific situation as others can be more experienced than them and can make their parenting life easier.
Nursing Interventions
Separation anxiety represents an element of interest at this age. Even though the child is trying to become more independent and also ask rarely for help, between the age of 6 months and until 2 years and a half, separation anxiety can represent a big point of interest. It explains why the child will immediately start to cry if he or she is surrounded by unknown people. In other to avoid separation anxiety, parents or familiar faces should be next to the child as much as possible. This will avoid the distress and will also help the child handle better the stressors factor. This theory is also an explanation for why most of the parents are admitted together with their children in the pediatric units.
Incapacity to express themselves represents another barrier at this age. Because of that, the child needs to richen his or her vocabulary in order to be able to express the feelings better. A way to do this is to instruct the parents that they should try to limit watching television to 1 to 2 hours per day as this represents a type of activity that doesn't stimulate speaking. Whenever the child is watching the television, the parent should sit next to them and encourage them to discuss what they see. They should also focus on stimulating the child to talk whenever they are together such as when having a family dinner or when reading a bedtime story.
Picky eating represents another problem at this age because it is generally accepted that children and also senior people need an adequate intake of nutrients in order to stimulate their immune system and the growth process. Because of that, it is important for the child to be able to have a correct intake in order to avoid developmental pathologies. The problem begins during the period when most of the children become picky and refuse to eat. The parents need to be instructed to avoid coaxing in this situation and rather trying to ignore it as it rarely lasts for too long. They shouldn't try to change too much the children diet and continue serving the same food full of nutrients. Even so, they need to take in mind that most of the children will eventually pass over this period and will be able to regulate their food intake best on their feeling of satiety and hunger.
Another intervention is represented by convincing parents to join planning cares and to set goals periodically. This will help them determine how much of their goals are ultimately met and also will promote the idea of meeting the needs of their children.
Nevertheless, the parents should be thought about different developmental tasks and activities which they can practice with their own children. They should be able to understand what the developmental level at a specific age is all about, to avoid putting to much stress on the 2-year girl.
Parents are always in a continuous state of stress. It is important for them to be able to maintain their health and get enough hours of rest in order to be able to participate in a diversity of activities. It is known that being a parent can be very time and also energy consuming and because of that they need to find techniques through which they are able to assist their child but also meet their own needs.
If the situation doesn't seem to improve, the parents should be referred to communities and support groups which will be able to instruct them what to do next and will help them determine what they are doing wrong. Putting aside the beauty of having a child, people often miss the stressful sleepless nights they have to bare for their own baby. Because of that, in some situations, they could feel better after exchanging a few information with others who are in a similar situation.
