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 Learning/Psychological 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 Psycho-social 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 Psycho-social 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 Add a strong statement that summarizes how you feel or think about this topic 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