Providing Developmentally Appropriate Care to Pediatric Patients

1. Providing Developmentally Appropriate Care to Pediatric Patients Your name, institution, date etc.

2. Introduction • State the purpose of the discussion • Identify yourself

3. Topics of Discussion • Developmental Stages • Child Friendly Interactions • Language Issues • Area Specific Procedures • Child Life Specialists and Preparation

4. 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)

5. 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

6. 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

7. Infants (0-12 months) • Fears • Greatest fear is the fear of separation from caregiver • After age 6 months, infants are afraid of strangers

8. 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

9. 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

10. Toddlers (1-2 years) • Fears • Separation • Loss of control • Pain • Altered rituals • Beginning to relate cause and effect, but no real concept of fear

11. Preschoolers (3-5 years) • Physical • Increasing fine motor skills • Gross motor skills becoming more coordinated

12. 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

13. 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

14. Preschoolers (3-5 years) • Fears • Mutilation • Loss of control • Death • The dark • May see illness/injury as punishment for “bad” behavior (still egocentric)

15. 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

16. 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

17. School-age Children (6-10 years) • Fears • Separation from friends • Loss of control • Physical disability

18. 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

19. 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

20. Adolescents (11-18 years) • Fears • Change in appearance • Dependency • Loss of control • Separation from peers

21. Child Friendly Interactions • Get on the child’s 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 – DON’T ASSUME

22. 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 don’t cry” • Talk to the patient and explain what you are doing • Use descriptive words

23. Area Specific Procedures / Real Life • Give an example or real life anecdote • Sympathize with the audience’s situation if appropriate • Give area specific guidelines/advice • Take questions about specific situations

24. 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

25. 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

26. Next Steps • Summarize any actions required of your audience • Summarize any follow up action items required by you