Intro to peds Flashcards
Describe Bronfenbrenners ecological system theory and the parts of it
This theory views child development as a complex system of relationships affected by multiple levels of the surrounding environment, from immediate setting of family and school to broad cultural values, laws, and customs
Includes macrosystem, exosystem, mesosystem, microsystem,
What is the EBD framework?
Developmental, behavioral and educational problems in childhood can have both long-term and intergenerational effects
Acknowledges concepts such as intergenerational trauma, childhood adversity and stress
What are the social determinants of health? What are the 5 areas?
Definition: conditions of the places in which children and families live, work, play and learn
5 areas: economic stability, education, social and community contexts, health and health care, neighborhood and built environment
SoDH contributes to 80-90% of health outcomes!
Examples of economic stability?
employment, food, housing security, sufficient resources
Examples of education within SoDH?
early childhood education, HS education, higher ed, language proficiency and literacy
Social and community contexts within SoDH?
civic participation, cultural social norms, attitudes
Health and healthcare within SoDH?
access to care, health literacy
Neighborhood and built environments within SoDH?
safety, access to healthy food, quality housing, opportunities for recreation
What is health equity?
Attainment of the highest level of health for all people
What is health inequity?
differences in health that are unfair, preventable, avoidable
What is ACES?
Adverse childhood experiences, persistent health disparities associated with poverty, discrimination or maltreatment
What populations are unrecognized and unmet therapy needs greater in?
Black and hispanic children
What is the health leads screening tool?
Pretty easy thing that patients can feel out that give you an idea if their needs are being met at home.
How does culture play into child development?
Culture frames child rearing – way child is introduced into society, toileting, feeding, handling, discipline, self help, play
The significance of a disability depends on the values and assumptions of the culture!
Culture influences maternal health seeking behaviors – problem recognition
What is cultural humility? (from a clinician standpoint)
“the understanding that in order to work with individuals who are culturally diverse, we understand that they are the experts on their culture and thought processes – we remain humble”
What are four goals of family centered intervention?
- Support the family unit
- Enhance family competence
- Enhance the growth, development, and functional independence of the child through a partnership with the family and child
- Care directed towards goals that are important and relevant to the family and child
Describe family centered care
Is a life span approach
Is a process that respects the rights and roles of family members while providing intervention
Fundamental premise: the child or person does not exist in isolation but functions within a family
The child is totally dependent on family members
What is the transactional model of development?
Reciprocal relationship between the child and the caregiving environment
A supportive environment may minimize biological risks
Support from social networks and the political and economical culture can influence how a family interacts and cares for their child
What constitutes a family?
Defined more by emotional and functional elements than by structural or legal elements
“A group of people who love and care for each other”
What is family systems theory?
all members are involved in each other’s lives so what happens to one member will effect the entire family
What are some guidelines of family centered care?
Family is recognized as key member of the team
Family is the consumer of services and retains ultimate decision-making authority
Professionals must value the family’s knowledge of their child
Therapists role: empowering, communication, enabling, support child
What are childrearing practices?
goal directed actions that parents engage in to promote their children’s development
How parents structure the learning and caregiving home environment may promote motor development
Describe parent-child interaction?
Intimate transaction
Basis for subsequent relationships
Influences skill acquisition
Predicated upon the notion that the child and caregiver have a dual responsibility to maintain the interaction
What are Barnard four features of successful child-parent interactions?
- Sufficient repertoire of behaviors, such as body movements and facial expressions
- Contingent responses to each other
- Rich interactive content in terms of play materials, positive affect, and verbal stimulation
- Adaptive response patterns that accommodate the child’s emerging developmental skills
How does PT play a role in parent-child interactions?
Atypical motor behaviors may influence the quality of parent-child interactions
Children with motor difficulties often demonstrate slow responses to external stimulation
Share information with parents about their child’s abilities and suggestions for optimizing interactions
What is the overarching goal of therapy for the child?
to optimize the child’s participation in the home, school, and community
What are the 4 parts of the intervention encounter?
1.Establish a common ground for communication and information sharing
2.The process of information gathering should involve methods acceptable to both parties
- Therapists and families should seek to create a good match among the child’s functional abilities, the family’s resources, the amount of information necessary to level the playing field, and the various environments that are important in the child’s daily life
- Intervention should focus on supporting the caregiving environment and the child’s participation regardless of the severity of the disability
What is the child abuse prevention and treatment act of 1974?
“the physical or mental injury, sexual abuse, negligent treatment or maltreatment of a child under the age of eighteen by a person who is responsible for the child’s welfare”
Requires every state to have a system for reporting suspected child abuse and neglect
Child abuse mandates a breach of confidentiality that is supported by federal law
Why are children with disabilities at an increased risk for abuse/neglect?
increased frustration from parents
Signs of abuse for child?
Sudden change in behavior or school performance
Has not received help for physical or medical problems brought to the parents’ attention
Has learning problems or difficult concentrating that cannot be attributed to specific physical or psychological causes
Is always watchful, as though preparing for something bad to happen
Lacks adult supervision
Is overly compliant, passive, or withdrawn
Comes to school or other activities early, stays late, and does not want to go home
Parent signs of abuse?
Shows little concern for the child
Denies the existence of – or blames the child for – the child’s problems in school or at home
Asks teachers or other caregivers to use harsh physical discipline if the child misbehaves
Sees the child as entirely bad, worthless or burdensome
Demands a level of physical or academic performance the child cannot achieve
Looks primarily to the child for care, attention, and satisfaction of emotional needs
Interactions between child and parent that indicate abuse?
Rarely touch or look at each other
Consider their relationship entirely negative
State that they do not like each other
What are the different types of abuse?
Physical
Neglect
Sexual
Emotional
(usually found in combination)
Signs of physical abuse?
Unexplained burns, bites, bruises, broken bones or black eyes
Fading bruises or other marks noticeable after an absence from school
Seems frightened of the parents and protests or cries when it is time to go home
Shrinks at the approach of adults
Head and brain injuries
Internal injuries
Signs of neglect
Signs of Neglect: neglect occurs when the child’s basic needs are not being met
Malnourishment including reports of hunger, nutritionally inadequate diet
Medical neglect (parental refusal to seek or maintain necessary medical intervention including dental care, excessive cancellations)
Educational neglect (parental indifference to the child’s school attendance or cognitive development)
Emotional neglect (parental indifference to child’s need for physical contact and psychological nurturance)
Evidence of poor hygiene including soiled clothing and skin, skin breakdown in diaper area)
Signs of sexual abuse
Signs likely to be behavioral including anorexia, bulimia, eneuresis, encopresis, abdominal pain without organic cause, atypical shyness, extroverted or hostile behavior, sexual acting out
Difficulty walking or sitting
Suddenly refuses to change for gym or participate in physical activities
Nightmares
Bizarre or unusual sexual knowlegde
Becomes pregnant or contracts VD
Runs away
Signs of emotional maltreatment
Extremes in behavior – overly compliant or demanding, extreme passivity or aggression
Is inappropriately adult or infantile
Delayed physical or emotional development
Attempted suicide
Lack of attachment
What is Munchausen syndrome by proxy?
Specialized form of child abuse is which a physical or mental disorder of the child is either fabricated or induced by a parent or other adult caretaker
Warning signs for munchausen syndrome by proxy?
Persistent or recurrent illnesses for which a cause cannot be found
Discrepancies between history and clinical findings
Symptoms and signs that do not occur when a child is away from the mother
Unusual symptoms that do not make clinical sense
Persistent failure of a child to tolerate or respond to medical therapy without clear cause
A parent less concerned than the physician, sometimes comforting the medical staff
Repeated hospitalizations and vigorous medical evaluations of mother or child without definitive diagnoses
A parent who welcomes medical tests on her child, even if painful
What are the models of service delivery?
-Multidisciplinary
Professionals work independently but recognize and value the contributions of other professions
Interdisciplinary
Individuals from different disciplines work together cooperatively to evaluate and develop programs.
Emphasis is on teamwork. Role definitions are relaxed.
-Transdisciplinary
There is teaching and ongoing work among professionals across traditional disciplinary boundaries. Role release occurs when a team member assumes the responsibilities of other disciplines for service delivery
