Providing Developmentally Appropriate Care to Pediatric

Patients 

Your name, institution, date etc.

Introduction

• State the purpose of the discussion

• Identify yourself

Topics of Discussion

• Developmental Stages

• Child Friendly Interactions

• Language Issues

• Area Specific Procedures

• Child Life Specialists and Preparation

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)

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

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

Infants (0-12 months)

• Fears– Greatest fear is the fear of separation from

caregiver– After age 6 months, infants are afraid of

strangers

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

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

Toddlers (1-2 years)

• Fears– Separation– Loss of control– Pain– Altered rituals– Beginning to relate cause and effect, but no real

concept of fear

Preschoolers (3-5 years)

• Physical– Increasing fine motor skills– Gross motor skills becoming more coordinated

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

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

Preschoolers (3-5 years)

• Fears– Mutilation– Loss of control– Death– The dark– May see illness/injury as punishment for “bad”

behavior (still egocentric)

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

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

School-age Children (6-10 years)

• Fears– Separation from friends– Loss of control– Physical disability

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

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

Adolescents (11-18 years)

• Fears – Change in appearance– Dependency– Loss of control– Separation from peers

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

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

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

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

What This Means

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• Summarize key points you want you audience to remember

Next Steps

• Summarize any actions required of your audience

• Summarize any follow up action items required by you