Chapter 11 Flashcards
Play in the School Age Child
and Adolescent
- Play is a child’s primary occupation
- Important vehicle to ease tension
- Being “too old” for play
- Sports as play participation in adolescents
- The impact of socio-economic status on play
Health professionals often present types of authority
that are unfamiliar to the child.
Play is a child’s primary occupation
child’s right to “engage in play and recreational activities appropriate to the age of the child.”
Some older children who become patients may regress
regress to an earlier stage of play, but many will assume roles at the higher levels of play, which will allow them to act out their predicament of being in a new situation.
associative play
can involve playing “hospital” with a health professional or family member.
children can be sensitive about being “too old” for certain types of toys
health professionals and others must think carefully about which toys to offer and how to integrate family and siblings into their sessions
Rather than stereotyping masculine or feminine toys,
health professional should use open-ended questions to learn from the young patient about their preferences. They will likely enjoy sharing about their favorite game or toy.
The poverty threshold for a family of four in the United States is $26,172
In 2019, 14% of those under the age of 18 were living in poverty.
Children living in poverty are often vulnerable
to environmental, health, educational, and safety risks. They are also at particular risk for developmental challenges.
School Issues
School as major transition
Each school-based transition brings a period of adjustment to new rules, teachers, friends, and environments. Emotions related to school transitions include excitement, happiness, sadness, and worry
schools provide children with many other services beyond academics.
Schools can be the main source of food for children.12 Many children, especially those from minoritized backgrounds or with lower socioeconomic status, rely on school for health care and mental health services.
Even a short illness or injury may disrupt school attendance
put the child behind in schoolwork, and have social consequences.
Feelings of self worth
usually tied to school for
children
Disability at the school level through the ICF
lens
- focus on functioning in society regardless of the reasons for limitations.
- a biological, individual, and social perspective of health rather than a diagnosis or label
Rising number of US children with
developmental disabilities
- 17% of school-age children had a developmental disability.
- this percentage increased over the two time periods compared, 2009–11 and 2015–17
ADA American disabilities Act and Individuals with Disabilities Education Act (IDEA). Individualized Education Program IEP
requires public schools to make available to all eligible children with disabilities a free, appropriate public education in the least restrictive environment appropriate to their individual needs
IDEA
individualized education program (IEP)
if parents disagree with the IEP:
(1) mediation,
(2) complaint, and
(3) a due process hearing.
Needs of the School Age Child
- Evolve around tasks, hobbies, and activities
- Rely on active participation in the care planning process so that they learn the life skills necessary for decision making and disease management
Children value the following in their health care
provider:
- Good communication
- Professional competence
- Safety / appearance
- Virtues
- Fun
parents of children in a pediatric intensive care unit
described that it is vital that providers keep them informed.
parents observed the interprofessional care team working together
, they described their burden being lowered
Tasks to Lower Family Stress
- Providing information
- Families as collaborators of care
- Provided with updated information through structured communication
- Supporting siblings
- Involving family members in care of the child
- Learning patient care tasks can reduce the sense
of powerlessness - E.g. positioning in bed, assisting with bathing or ADL care
Children as Active Participants in Care
many policies now acknowledge the importance of listening to children and having them assent to care decisions. consent asked for at age 7.
help siblings cope
by providing support and information. Through the application of the principles of patient and family-centered care, supportive participation, information sharing, and collaboration, siblings feel engaged and supported.
adolescent
“to grow into maturity or adulthood”
Early and late adolescence
Early: first two years: growth spurts, maturing of reproductive functions and sex organs, increased weight, and changes in body proportions
Late: self-identity fully emerges as they practice the various roles and responsibilities they will assume as adults.
Physiological and self image changes in the
development of autonomy
They will try various roles to integrate their developing social skills with goals and dreams.
disconnect between physical development and psychosocial maturation, leading to many of the challenges of adolescence
Friends and Peer Groups
Adolescents tend to spend less time with family
more time in new environments such as work settings, peer relationships, and romantic relationships.
Friends and Peer Groups
Substance use (tobacco, marijuana, and alcohol use), violence (weapons and physical fighting), and suicidal behavior (suicidal ideation and attempts)
relate to a teen’s friends’ substance use, deviance, and suicidal behaviors, respectively.
Friends and Peer Groups
Peers
help teens learn social norms and provide the support needed during the challenging time of adolescence.
Digital media and the teenage brain
electronic media have both positive and negative effects on adolescents.
Social media and gaming can influence the brain’s reward circuitry
Among the positives (digital media)
access to health information, social connections, and expanded learning opportunities
Legal rights of adolescents (mature minor)
Mature Minors Doctrine
allows for parents or the state to speak on behalf of a minor’s interests only if the minor is unable to represent themselves.
Connections between behavior patterns and
long term consequences for health
degree of experimentation and risk taking seem[s] to be an integral part of the transition from childhood to adulthood,… be able to identify those at most risk of adverse consequences, without interfering with normal development
Programs to promote healthy lifestyles for adolescents
should include information on nutrition, activity, stress management, family planning, prevention of smoking, alcohol and substance abuse, safety (particularly digital and motor vehicle safety), and sexual and mental health.
The family dynamic changes
as children and parents age.
. Families undergoing changes to their structure and dynamics
may exhibit higher levels of conflict during a child’s illness
