Communication - Younger Patients

Question 1

Piaget proposed 4 different stages of cognitive development. What are they?

Answer 1

1) Sensorimotor (0-2 years)
2) Preoperational (2-7 years)
3) Concrete operational (7-11 years)
4) Formal operational (12 years and up)

Question 2

What is Sensorimotor (0-2 years)?

Answer 2

Characteristics
Experience of the world through movements and sensations

Developmental changes
- objective permeance
- infants are separate beings from the world around them
- They realize actions can cause things to happen around them, causality
-Learning occurs through assimilation and accommodation

Question 3

What is Preoperational (2-7 years)?

Answer 3

Characteristics
Symbolic thinking (words/objects)
Egocentrism

Developmental changes
- Thinking still very concrete although it improves with language
- Children struggle to see things from others’ perspective

Question 4

What is Concrete operational (7-11 years)?

Answer 4

Characteristics
Logical thinking about concrete events

Developmental changes
-Concept of conservation
- Thinking becomes logical and organised, concrete inductive reasoning (specific information to general principle)

Question 5

What is Formal operational (12 years and up)?

Answer 5

Characteristics
Abstract thinking and reasoning concerning hypothetical problems

Developmental changes
- Abstract thought
-Teens begin to think more about moral, philosophical, ethical, social and political issues that require theoretical and abstract reasoning.
- Begin to use deductive logic, or reasoning from a general principle to specific information.

Question 6

What is the attachment theory?

Answer 6

Attachment theory (John Bowlby,1969) describes the dynamics of long-term
relationships between humans. Its most important principle is that an infant
needs to develop a relationship with at least one primary caregiver for social and
emotional development to occur normally.

Question 7

What is separation anxiety?

Answer 7

Separation anxiety: this occurs at around 7-12 months where the child
starts feeling distressed when the mother is absent.
* Before the 1960s, if children were hospitalized, mothers were asked to
leave their children in the hospital and not visit because children would
be distressed every time their mothers left.
* As a result of various studies during that period, policies were reversed:
mothers are now encouraged to stay, if possible for the duration of the
child’s admission to hospital

Question 8

How do you reduce pain in children?

Answer 8

Positive Reinforcement - Providing information before, during and
following the procedure. Preparation can decrease anxiety associated
with fear of the unknown and unexpected.
* Explain procedures using age-appropriate props - Pictures, diagrams
and child friendly models using age appropriate language. Watch a DVD
of procedure (in adolescents) and play through a procedure with dolls or
a demonstration on a doll for younger children.
* Distraction – Involve parents / carers to help focus child’s attention on
something other than the painful procedure.
* Useful interventions during painful procedures - music, controlled
breathing and imagery.