Communication and Physical Assessment of the Child and Family

Communication and Physical Assessment of the Child and Family

Communicating with Children

• Importance of creating a safe environment
  • Introduce yourself
  • Involve the child from the beginning of the interaction
  • PLAY, PLAY, PLAY
  • Get eye level
  • Take your time
  • Explain the purpose of the exam in age-appropriate terms
  • Provide privacy
  • Direct the focus 
  • Ask one question at a time
  • Be honest
  • Keep language and understanding as a focus
• Careful listening
  • Pay attention to how information is expressed
  • Observe behaviors during the interaction
    • Pay attention to the tone of voice
      • Anxiety, fear, anger
    • Be alert to underlying themes
    • Observe non-verbal behavior
      • Posture, gestures, eye contact

Communication Related to Development of Thought process

• Infancy: 
  • nonverbal communication, gentle handling, quiet environment, calm speech
• Early Childhood:
  • Under 5 are egocentric, focus the communication on them; include them in the exam, unable to think abstractly
    • Use simple direct language
• School Age:
  • They want explanations and reasons for everything; heightened concern about body integrity; encourage communication
• Adolescence:
  • Thinking fluctuates between child and adult thinking; be prepared to be flexible 
    • Interviewing poses special considerations regarding parental involvement.

Facilitating examination of Infants

• Promote physical comfort and relaxation
• Distract infant with colorful toys
• Use gentle, warm hands 
• Do procedures that provoke crying at end of exam

Facilitating examination of Toddlers

• Keep child close to parent (Preverbal)
• Provide a security object
• Demonstrate instruments on parent or other before examining child
• Allow child to have as much control and choice as possible
• Examine ears, eyes, mouth at end of the exam

Facilitating examination of Preschoolers

• Consider what sequence is best
• Allow children to touch and play with equipment
• Use games to reduce anxiety
• Give positive feedback

Facilitating examination of Older Children and Adolescents

• Ensure modesty and privacy
• Offer choices
• Explain body parts and functions
• Decide on parental presence or absence
• Reassure adolescents of normalcy