We discusses in detail about the assessment of an adult. we wire with discuss mainly about the assessment of a child.
Physical Growth
A child’s level of physical growth is assessed by determining weight, height, vital signs and by physical examination.
Weight
Weighing a child gives information in two crucial areas. The current weight and his decrease/increase in weight. Child’s weight has to be interrelated against his birth weight, whether it is a normal increase for him. Infants should be weighed nude. They should be weighed on an infant scale unless they are 1 year old or until they can stand.
Height
An infant’s height is measured by placing the child on a supine position over a firm board. We can use a measuring board when the scaling is pre-recorded. If this is not available, prepare the scale on a chart paper and place it under the child. You can also mark with pencil the scale points,i.e., (a) heels, (b) top margin of the head .Now measure the distance between (a) and (b). This will give you the length/height of the child.
Height and weight should be plotted on a standard growth charts to interpret the measurements.
Head and Chest Circumference
Head circumference reflects brains growth. Too rapid growth of head circumference suggests abnormal brain growth or collection of fluid inside the skull. To measure head circumference, the tape measure should cross forehead just above the eyebrows and pass around the widest point of the skull at the back, the occipital prominence Chest circumference is measured at the nipple line.
Head circumference and chest circumference are measured routinely in children up to 2 years of age Vital Signs
Vital signs differ according to the size and age of the child. As the child grows older the heart rate slows and the range of normal values narrows. Pulse rate and respiration should preferably be measured with the child at rest. For an infant apical pulse (listening at the heart apex through a stethoscope) is taken. For greatest accuracy pulse and respiration should be counted for a full minute. Blood pressure should be included in the routine physical assessment of all children over 3 years of age.
Temperature values in children are the same as in adults, axillary 97.6°F (36.5°C) Oral 98.6 °F(37°C). Newborn’s temperature should be taken in axila. Rectal temperature should be avoided because of the temperature danger of damaging their rectal mucosa. Until age of four years axillary temperature only should be taken. The thermometer should remain in place for 3 minutes.
Physical Examination
To make a person comfortable with physical examination, it is important to talk to them. Before examining children, allow children to handle equipment and explain them before doing anything The four technique of physical examination includes inspection, palpation, percussion andauscultation. Basic equipment includes a stethoscope, tongue depressor, ophthalmoscope,otoscope, sphygmomanometer, tape measure and reflex hammer.
The physical examination of an individual. In case of children the extent and techniques of physical examination varies according to children’s age. In case of new born, undress only the body part being examined or use radiant heat warmer to conserve heat.Examine heart and respiratory systems first before infant cries, and then follow head to toe procedure. Infants are examined similarly as newborn. Talk to the infants as you proceed. Allow toddlers to handle equipments. Preschoolers should be involved in some play activities, when examining them, School age children and adolescents can be asked whether they want parents present or not. They can be explained equipments and reasons for procedure .
Developmental Assessment
One of the most important components of a complete health appraisal is assessment of developmental functioning. Various screening procedures are designed to identify those children whose developmental level is below normal for their age and require further investigation. They also provide a means of recording objective measurement of present developmental functioning for future reference.
Physical Growth
A child’s level of physical growth is assessed by determining weight, height, vital signs and by physical examination.
Weight
Weighing a child gives information in two crucial areas. The current weight and his decrease/increase in weight. Child’s weight has to be interrelated against his birth weight, whether it is a normal increase for him. Infants should be weighed nude. They should be weighed on an infant scale unless they are 1 year old or until they can stand.
Height
An infant’s height is measured by placing the child on a supine position over a firm board. We can use a measuring board when the scaling is pre-recorded. If this is not available, prepare the scale on a chart paper and place it under the child. You can also mark with pencil the scale points,i.e., (a) heels, (b) top margin of the head .Now measure the distance between (a) and (b). This will give you the length/height of the child.
Height and weight should be plotted on a standard growth charts to interpret the measurements.
Head and Chest Circumference
Head circumference reflects brains growth. Too rapid growth of head circumference suggests abnormal brain growth or collection of fluid inside the skull. To measure head circumference, the tape measure should cross forehead just above the eyebrows and pass around the widest point of the skull at the back, the occipital prominence Chest circumference is measured at the nipple line.
Head circumference and chest circumference are measured routinely in children up to 2 years of age Vital Signs
Vital signs differ according to the size and age of the child. As the child grows older the heart rate slows and the range of normal values narrows. Pulse rate and respiration should preferably be measured with the child at rest. For an infant apical pulse (listening at the heart apex through a stethoscope) is taken. For greatest accuracy pulse and respiration should be counted for a full minute. Blood pressure should be included in the routine physical assessment of all children over 3 years of age.
Temperature values in children are the same as in adults, axillary 97.6°F (36.5°C) Oral 98.6 °F(37°C). Newborn’s temperature should be taken in axila. Rectal temperature should be avoided because of the temperature danger of damaging their rectal mucosa. Until age of four years axillary temperature only should be taken. The thermometer should remain in place for 3 minutes.
Physical Examination
To make a person comfortable with physical examination, it is important to talk to them. Before examining children, allow children to handle equipment and explain them before doing anything The four technique of physical examination includes inspection, palpation, percussion andauscultation. Basic equipment includes a stethoscope, tongue depressor, ophthalmoscope,otoscope, sphygmomanometer, tape measure and reflex hammer.
The physical examination of an individual. In case of children the extent and techniques of physical examination varies according to children’s age. In case of new born, undress only the body part being examined or use radiant heat warmer to conserve heat.Examine heart and respiratory systems first before infant cries, and then follow head to toe procedure. Infants are examined similarly as newborn. Talk to the infants as you proceed. Allow toddlers to handle equipments. Preschoolers should be involved in some play activities, when examining them, School age children and adolescents can be asked whether they want parents present or not. They can be explained equipments and reasons for procedure .
Developmental Assessment
One of the most important components of a complete health appraisal is assessment of developmental functioning. Various screening procedures are designed to identify those children whose developmental level is below normal for their age and require further investigation. They also provide a means of recording objective measurement of present developmental functioning for future reference.
Denver Developmental Screening Test (DDST)
DDST and Revised Denver Development Screening test (DDST -R) are the most widely used screening. tests to assess development, of a child. It detects developmental delays from birth until 6 years of age. Four main categories are rated: personal-social, fine motoradaptation, language and gross motor skills. The material to administer the test must be purchased as a kit. A training module with manual and workbook and demonstration film has been developed. DDST is designed for administration by professionals and para- professionals and takes about 15 to 20 minutes to complete. Parents should be told prior to administration that this is not a test of intelligence but of the child’s level of development.
Some things you will ask the child to do he will accomplish easily; in each category there will be some items he will not be able to perform. By counting the number of accomplished and unaccomplished items, you will arrive at an estimate of his developmental level.A Denver Prescreening Developmental Questionnaire (PDQ) is available in addition to DDST.The PDQ is a questionnaire of ten developmental items that the parents fill in. It is designed to identify the child who requires further testing with a full DDST.
Intelligence
The child must, learn many important concepts or ideas before s/he can function effectively in the world. The child must learn about numbers, how to judge time intervals, how to reason and solve problems, own body parts and functions. This type of bearing is called cognitive learning. It is measured by intelligence tests. Intelligence is defined as an ‘‘ability to think abstractly, to adjust to new situations and to profit from experience. There are various tests available for testing the Intelligence. The most common tests used for children are Wechsler Intelligence scale for children and the Stanford Binet Intelligence scale. A good enough Draw-a-Man Test is a quick intelligence measurement that can be administered without special training.
DDST and Revised Denver Development Screening test (DDST -R) are the most widely used screening. tests to assess development, of a child. It detects developmental delays from birth until 6 years of age. Four main categories are rated: personal-social, fine motoradaptation, language and gross motor skills. The material to administer the test must be purchased as a kit. A training module with manual and workbook and demonstration film has been developed. DDST is designed for administration by professionals and para- professionals and takes about 15 to 20 minutes to complete. Parents should be told prior to administration that this is not a test of intelligence but of the child’s level of development.
Some things you will ask the child to do he will accomplish easily; in each category there will be some items he will not be able to perform. By counting the number of accomplished and unaccomplished items, you will arrive at an estimate of his developmental level.A Denver Prescreening Developmental Questionnaire (PDQ) is available in addition to DDST.The PDQ is a questionnaire of ten developmental items that the parents fill in. It is designed to identify the child who requires further testing with a full DDST.
Intelligence
The child must, learn many important concepts or ideas before s/he can function effectively in the world. The child must learn about numbers, how to judge time intervals, how to reason and solve problems, own body parts and functions. This type of bearing is called cognitive learning. It is measured by intelligence tests. Intelligence is defined as an ‘‘ability to think abstractly, to adjust to new situations and to profit from experience. There are various tests available for testing the Intelligence. The most common tests used for children are Wechsler Intelligence scale for children and the Stanford Binet Intelligence scale. A good enough Draw-a-Man Test is a quick intelligence measurement that can be administered without special training.
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