Child Development, Communication and Management

Question 1

Describe the development of a 2 year old pre-school child:

Answer 1

• pre-cooperative: overwhelming, don’t understand, awkward to deal with
• dependent on parent, poor communication skills, do not share or play well
• communicate mostly by crying as the default to tired, hungry, thirsty, frightened
• time issues in concentration and sitting still
• parental support and education is key in this age group

Question 2

Describe a 3 year olds development:

Answer 2

• similar aspects to a 2 year old in crying for communication but should have some verbal skills to enhance understanding which relieves frustration
• like to be grown up: mimic adult behaviour
• should respond well to colourful descriptive stories to capture imagination
• still time issues - need to be quick

Question 3

Describe the development of a 4 year old:

Answer 3

• they want to do things their way: will test the boundaries
• child brushes themselves but realistically need parent to do it/supervise
• communication and interaction skills improve - potentially cooperative

Question 4

Describe a school childs development:

Answer 4

• egocentric and inflexible - constant until about 7/8 years
• more independent and need less parental support, concentration improving but still a problem for long periods of time
• respond to praise and flattery, complement what they are wearing or anything to make a fuss
• love to show off their possessions so show an interest
• children of 7 years can separate messages and deem the ones that are important and ones that are not
• have physical ability to brush teeth but lack motivation so still need supervision
• beginning of logical reasoning and acceptance of alternative aspects

Question 5

Describe an adolescence development:

Answer 5

• increasing independence
• major emotional, hormonal and physical changes
• do not criticise, very moody, sensitive, so comments need to be delivered with care
• difficulties with motivation but can deal with cause and effect relationships in health but still better in present day than future (don’t think of the consequences of not brushing today and how that will affect 5 years time)

Question 6

What tactics can you use to win 2 year olds over:

Answer 6

• self centred, easily distracted, attention 1-5 mins, only focus on one thing at a time, favourite word is NO, separation anxiety from parent
• keep appointments short, little and often
• don’t ask questions that have the opportunity to answer no
• invite parent into surgery
• full concentration on child and don’t talk chinese to parent infront of child as will lose childs attention
• avoid sudden movements or too much working from behind

Question 7

What tactics can you use on a 3 year old?

Answer 7

• mimics adult behaviour, increasing levels of independence, curious and imaginative, wants to please you, asks WHY to most things
• get and keep attention by arousing curiosity
• helping hands: beware of child grabbing instruments from bracket table
• positive attitude e.g. I’ve got a special way, easier this way etc
• negative attitude of ‘do not do that’ tend to alienate or frighten

Question 8

What tactics can you use on a 4 year old?

Answer 8

• insistent and impatient, bossy, tests dominance, has simple reasoning skills and will accept changes if presented properly, enjoys variety
• explain simple procedures - stay open wide and why its important
• keep control, work steady, avoid delays in procedures where possible

Question 9

What tactics can you use with a 5-8 year old?

Answer 9

• poised and aware of rules, self confidence growing and acts grown up, accepts authority, less argumentative, materialistic and proud of possessions, don’t be negative - sensitivity issues and hurt feelings
• show interest in new clothes or items brought into surgery
• appeal to egocentricity/vanity - clean dirty tooth to fill with a shiny star
• give praise - lots of it throughout
• steady and unfaltering concentration on child
• teach stop signal (raise hand) and practice to reassure you will stop

Question 10

How is the relationship between age and behaviour characterised?

Answer 10

• cooperative
• potentially cooperative
• pre-cooperative - lacking cooperative ability
  Cooperation is mostly dependent on age

Question 11

What is a pre-cooperative child?

Answer 11

• a child who lacks ability to be cooperative and includes communication issues in the preschool child and with certain disabilities
  This category need different approaches which may include GA

Question 12

What is internal and external locus of control?

Answer 12

Internal: they can control what happens to them or responsible for their own health
- these children need specific information regarding treatment as it gives them a feeling of expectation and control over the procedure
- if this is ignored and general info given –> child more likely to feel anxious
External: what happens is down to chance and has no personal input
- these children respond better to an outline of session as details will increase anxiety

Question 13

What are some important points when communicating with the paediatric patient?

Answer 13

• balancing act: inform parent and child
• ensure child is centre of attention
• message you think you are sending may not be what the family are receiving
• gain parents opinions on childs dental health
• respect parents desires even if you disagree
• relieve some of parents feelings of guilt and anxiety
• encourage positive, health promoting behaviour
• encourage parents to reinforce childs positive cooperative behaviour
• dont use jargon to explain procedures
• discuss various treatment options without biasing the decision

Question 14

Name some specific management techniques:

Answer 14

• introduce in stages
• teach relaxation breathing/imagery
• tell, show, do
• reinforcement and reward
• modelling
• distraction