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

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