Developmental assessment – Health of the children has been considered as the vital importance to all societies because children are the basic resource for the future of humankind. Nursing care of children is concerned for both the health of the children and for the illnesses that affect their growth and development. The increasing complexity of medical and nursing science has created a need for special area of child care, i.e. pediatric nursing.
Pediatric nursing is the specialized area of nursing practice concerning the care of children during wellness and illness. It includes preventive, promotive, curative and rehabilitative care of children. It emphasizes on all round development of body, mind and spirit of the growing individual. Thus, pediatric nursing involves in giving assistance, care and support to the growing and developing children to achieve their individual potential for functioning with fullest capacity.
Developmental assessment
Assessment of Growth of a Child:
Height
At birth-50 cm
1 year – 75 cm
2 years – 80 cm
3 years increase 5 cm/year
Weight
Birth weight: 2.5-4.0 kg
First 3 months: 30 g
3-6 months: 20 g (birth weight doubles by 5-6 months of age)
6-9 months: 15 g
9-12 months: 12 g (birth weight triples by first birthday)
1-3years: 8 g (around 3 kg/year). Birth weight quadruples by 2 years of age.
4-6years: 6 g (around 2 kg/year); this rate of gain continues till the onset of puberty
Occiputo-frontal circumference
At birth-35 cm
1 year – 45 cm
2 years – 48 cm
Mid arm circumference
Normal> 13.5 cm
Borderline PEM-12.5-13.5 cm
Malnourished-< 12.5 cm
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Danger Signs of Development;
By looking some of the signs at appropriate age one can assume that the child is not developing properly. These signs if present indicate developmental delay and requires immediate assessment and intervention with appropriate management preferably in a child development centre.
Age
Danger sign / Warning sign
By the age of one month
Poor suckling at the breast or refusing to suckle.
Little movement of arms and legs.
Little or no reaction to loud sounds or bright lights.
Crying for long periods for no apparent reason.
Vomiting and diarrhea, which can lead to dehydration.
By the age of six months
Stiffness or difficulty moving limbs.
Constant moving of the head (this might indicate an ear infection, also indicate deafness, blindness, mental retardation).
Little or no response to sounds familiar faces or the breast.
Refusing the breast or other food.
Absence of neck control, persistence of premature reflex.
By the age of 12 months
Does not make sounds in response to others.
Does not look at objects that move.
Listless and does not respond to the care giver.
Has no appetite or refuses food.
By the age of two years
Lack of response to others.
Difficulty keeping balance while walking.
Injuries and unexplained changes in behavior. (Especially if the child has been cared for by others)
Lack of appetite.no
By the age of three years
Loss of interest in playing.
Frequent falling.
Difficulty manipulating small objects.
Failure to understand simple messages.
Inability to speak using several words.
Little or no interest in food.
By the age of five years
Observe the roles children take in play. If the child is fearful, angry or ‘violent, these may be signs of emotional problems or abuse.
