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SPRING16 N833 Adv Pedi > School Readiness > Flashcards

School Readiness Flashcards

1
Q

Erikson’s Stages of Psychosocial Development: Preschool (3-5yo)

A

Initiative vs Guilt

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2
Q

Characteristics of Erikson’s “initiative vs guilt” stage

A

(preschool - 3-5yo)

Children begin to assert themselves, plan activities, make up games, and initiate activities

Resolution: Purpose

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3
Q

Erikson’s Stages of Psychosocial Development: School age (6-11yo)

A

Industry vs inferiority

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4
Q

Characteristics of Erikson’s “industry vs inferiority” stage

A

(School age - 6-11yo)
Children need to cope with new social and academic demands

Resolution: Competence

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5
Q

Piaget’s Stages of Cognitive Development: 2-7 yo

A

Preoperational Stage

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6
Q

Characteristics of Piaget’s Preoperational Stage

A 
(2-7 yo)
Key feature: Centration
Egocentrism
Language development
Symbolic representation
Irreversibility
Animism
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7
Q

Piaget’s Stages of Cognitive Development: 7-11 yo

A

Concrete operational

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8
Q

Characteristics of Piaget’s Concrete operational stage

A 
Key feature: Conservation
Thinking logically about concrete events
Reversibility
Seriation 
Decentering
Ability to do math
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9
Q

Kohlberg’s stages of Moral Dvpt: stage all children are in

A

Preconventional

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10
Q

Characteristics of Kohlberg’s pre-conventional stage (stage 1)

A

Authority is outside of the individual and reasoning is based on the physical consequences of actions
Stage 1: Obedience/Punishment
Child is good in order to avoid being punished
If punished, they must have done something wrong

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11
Q

Characteristics of Kohlberg’s pre-conventional stage (stage 2)

A

Authority is outside of the individual and reasoning is based on the physical consequences of actions

Stage 2: Self-interest driven
What’s in it for me?
Child is good in order to obtain rewards
Begin to recognize that there is not just one right view

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12
Q

Social and emotional dvptl milestones at 3 years

A

Copies adults and friends
Shows affection for friends without prompting
Shows a wide range of emotion
Understands concept of “mine” and “his” or “hers”

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13
Q

Language/communication dvptl milestones at 3 years

A

Follows instructions with 2 or 3 steps
Talks well enough for strangers to understand most of the time
Carries conversation using 2 to 3 sentences

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14
Q

Cognitive dvptl milestones at 3 years

A

Plays make-believe with dolls, animals, and people
Copies a circle
Builds towers of more than 6 blocks
Does puzzle with 3 or 4 pieces

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15
Q

Movement/Physical Development

milestones at 3 years

A

Climbs well
Runs easily
Walks up and down stairs, one foot on each step

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16
Q

Social and emotional dvptl milestones at 4 years

A

Is more and more creative with make-believe play
Would rather play with other children than by himself
Talks about what she likes and what she is interested in

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17
Q

Language/communication dvptl milestones at 4 years

A

Tells stories
Knows some basic rules of grammar
Can say first and last name
Sings a song or poem from memory

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18
Q

Cognitive dvptl milestones at 4 years

A

Names some colors and numbers
Draws a person with 2-4 body parts
Starts to understand time
Tells you what he thinks is going to

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19
Q

Movement/Physical Development

milestones at 4 years

A

Hops and stands on one foot for up to 2 seconds
Catches a bounced ball most of the time
Pours, cuts with supervision, and mashes own food

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20
Q

Social and emotional dvptl milestones at 5 years

A

Wants to please and be like friends
More likely to agree with rules
Is aware of gender
Can tell what is real and what is make-believe

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21
Q

Language/communication dvptl milestones at 5 years

A

Speaks very clearly
Tells a simple story using full sentences
Uses future tense
Says name and address

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22
Q

Cognitive dvptl milestones at 5 years

A

Counts 10 or more things
Can draw a person with at least 6 body parts
Can print some letters or numbers
Knows about things used every day like money or food

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23
Q

Movement/Physical Development

milestones at 5 years

A

Hops; may be able to skip
Uses a fork and spoon, sometimes a table knife
Can use toilet on their own
Swings and climbs

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24
Q

In 1991, the National Education Goals Panel adopted as its first goal that …

A

“by the year 2000, all children will enter school ready to learn”

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25
Q

Components of School Readiness

A

Readiness of the child
School’s readiness for children
Family and community supports contributing to child readiness

(multidimensional, interdependent)

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26
Q

Common Misconceptions about school readiness

A

Learning happens only at school
Readiness can be measured easily
Readiness is mostly a function of time (maturation) and some children need a little more
Children are ready to learn when they can sit quietly at a desk and listen
Children who are not “ready” do not belong in school

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27
Q

Five Dimensions of Readiness

A

Physical Well-Being and Motor Development

Social and Emotional Development

Approaches Toward Learning

Language Development

Cognition and General Knowledge

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28
Q 
5 Ds
#1: Physical Well-Being & Motor Development: Physical
A

Growth
Height, weight, maturation

Physical Fitness
Strength, energy, stamina, flexibility

Physiology
Optimal functioning of body systems

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29
Q 
5 Ds
#1: Physical Well-Being & Motor Development: Motor
A

Gross Motor Skills
Walk, run, jump, climb

Fine Motor Skills
Use scissors, fasten buttons

Sensorimotor Skills
Hear, see, touch, kick rolling ball

Oral Motor Skills
Sucking, producing sound, coordinating breathing

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30
Q

Significance of motor delays when assessing school readiness?

A

Motor delays may be first or most obvious sign of global developmental disorder

Early identification&raquo_space; Early interventions

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31
Q

AAP recommendations regarding motor delay screenings

A

Standardized developmental screening (including motor development) at 9, 18, and 30 months
Additional screening test at 4 years before child enters Kindergarten

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32
Q

Motor expectations at 9mo visit

A

infant rolling to both sides, sitting without support, showing motor symmetry without established handedness, grasping and transferring objects from hand to hand

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33
Q

Motor expectations at 18mo visit

A

toddler should sit, stand, walk independently; grasp and manipulate small objects; mild motor delays undetected at 9 months may be apparent at 18 months

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34
Q

Motor expectations at 30mo visit

A

most motor delays will have already been identified at previous visits; more subtle gross motor, fine motor, speech, and oral motor delays may emerge at 30 months; progressive neuromuscular disorders may emerge as loss of previously attained motor skills

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35
Q

Motor expectations at 48mo visit

A

preschooler should have early elementary school skills; emerging fine motor, handwriting, gross motor, communication, and feeding abilities that promote engagement with peers in group activities

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36
Q 
5 Ds
#2: Social and Emotional Development: Social
A

Ability to form and maintain social relationships with adults and peers

Communicate with adults and understand adult roles

Cooperate with peers

“Treat others as you would like to be treated”

Listen to others

Provide help and support for friends

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37
Q 
5 Ds
#2: Social and Emotional Development: Emotional
A

Ability to separate from parents

Self-regulation of emotions
Joy, fear, anger, grief, disgust, delight, horror, shame, pride, guilt, etc.

Self-confidence

Ability to understand feelings of others
Empathy, acceptance

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38
Q 
5Ds
#3: Approaches Toward Learning
A

Inclinations, dispositions, or styles that reflect how children become involved in learning

Predispositions:
Gender
Temperament (easy, slow to warm up, difficult)
Cultural Patterns and Values

Learning Styles:
Openness to and curiosity about new tasks and challenges
Initiative, task persistence, and attentiveness
Reflection and interpretation
Imagination and invention
Cognitive styles

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39
Q 
5Ds 
#4: Language Development
A

Listening
Speaking
Questioning
Social Uses of Language:Express emotions, get/give information, manners
Vocabulary: Understand words and sentences, Create complex sentences
Creative Language: Rhyming, storytelling
Literature Awareness: Interest in books/magazines, recall familiar stories
Print Awareness: Assigning verbal sounds to letters, recognize own name in writing
Aware of Story Sequence: Beginning, Middle, End
Writing: Ordered scribbling

40
Q 
5Ds
#5: Cognition and General Knowledge
A

Physical Knowledge
Learning about objects by observation and experience
E.g. A red, heavy ball rolling downhill

Logic-Mathematical Knowledge
Similarities, differences, and associations between objects, events, or people
E.g. A red and blue crayon are different based on color, but are the same based on size

Conventional Knowledge
ABCs, colors, numbers, etc.

Ability to use problem-solving and imagination

41
Q

Ways to evaluate Development & School Readiness (generally)

A

Developmental Surveillance

Screening Tools

Neurologic Exam

Artwork

42
Q

Developmental Surveillance: AAP recommends…

A

Developmental surveillance at ALL well-child visits

43
Q

5 Components of developmental surveillance

A

Eliciting and Attending to the Parents’ Concerns

Maintaining a Developmental History

Making Accurate and Informed Observations of the Child

Identifying the Presence of Risk and Protective Factors

Documenting the Process and Findings

44
Q

Developmental Screening Tools

A 
Ages & Stages Questionnaire
Denver II
Parents' Evaluation of Developmental Status (PEDS)
M-CHAT-R/F
Pediatric Symptom Checklist
45
Q

ASQ: what and who?

A

Ages 1 month to 5 ½ years
Parent-completed questionnaire
Screens communication, gross motor, fine motor, problem-solving, and personal adaptive skills

46
Q

Denver 2: what and who?

A

Ages 1 month to 6 years
Directly administered to child
Screens expressive & receptive language, gross motor, fine motor, and personal-social skills

47
Q

PEDS: What and who?

A

Birth to 8 years
Parent interview form
Screens for developmental & behavioral problems needing further evaluation

48
Q

M-CHAT-R/F: what and who?

A

Ages 18 months and 24 months (AAP Recommendation)
Parent-completed questionnaire
Identifies children at risk for Autism Spectrum Disorder

49
Q

PSC: what and who?

A

Ages 4 to 18 years
Parent-completed version and youth self-report (ages 11+)
Psychosocial screen to recognize cognitive, emotional, and behavioral problems

50
Q

Components of neuro exam

A

While taking history, observe child
Cranial Nerve Exam
Fundoscopic Exam: Detectable and symmetric red reflexes?
Facial Expressions: Quality of smile, cry
Oromotor Movement: Palate, tongue, Observe using straw or blowing kisses
Sensation: Test touch & pain sensation
Strength Assessment: Posture, grasp
Gait Assessment: Unsteady?
Deep Tendon Reflexes: Diminished? Absent? Increased?
Gross Motor Skills: Hop, run, skip, throw, stair climb, 1-foot stand
Fine Motor Skills: Button, zip, snap, tie, draw

51
Q

Dyspraxia =

A

inability to formulate, plan, and execute complex movements (test with gross and fine motor skills)

52
Q

Why use Draw-a-person test?

A

Originally developed to predict intelligence, now shows cognitive, motor, creative, visual, spatial, etc

53
Q

Stages of draw a person test

A 
Scribble stage (2-4y)
Pre-schematic stage (3-7y)
Schematic Stage (6-11y)
54
Q

Scribble stage of draw a person test

A

(2-4 years):
Random marks, dots, and lines
Kinesthetic and imaginative

55
Q

Pre-Schematic stage of draw a person test

A

(3-7 years):
Representative symbols for objects in environment
Circles, squares, and lines
Pictures are “floating”

56
Q

Schematic stage of draw a person test

A

(6-11 years):
Repetition of symbols for familiar objects
Ex. Lollipop tree, scarecrow-type people, row of identical houses)
Use of the “base-line”

57
Q

Standardized testing and school readiness?

A

Standardized testing may not be accurate or reliable indicator of school readiness
concerns re: labeling

58
Q

Current Connecticut Enrollment Requirements: Kindergarten

A

All children who turn 5 before January 1st of the current school year may enroll in kindergarten
Child must be enrolled in school by 7 years old
Children must have physical within last year
Up to date immunization records
CT Department of Early Child Education petitioning for change in date to October 1st of current school year

59
Q

Why would parents chose to delay kindergarten enrollment?

A

Age of child close to enrollment cut off

Development of child:
Delay in motor and gross development
Delay in social or emotional development
Delay in cognitive development
Delay in language development

Preference of parent :
Want child to enter old, taller, with higher cognitive and emotional skills

60
Q

What is Academic Redshirting?

A

4-5.5% of children delay kindergarten
Tend to be Male, White, High SES
Birthday close to cut off date
Low birth weight

61
Q

Performance differences in delayed enrollment?

A

Studies show that initially older children perform better, but that differences disappear by the 3rd grade

62
Q

What is academic greenshirting?

A

Early enrollment

Tends to be black, asian, low SES

63
Q

Why enroll early?

A

Cost of an additional year of preschool

64
Q

Child based RFs associated w/decreased school readiness

A 
Physical Disabilities
Learning Disabilities
Intellectual Disabilities
Emotional and social maladjustments
Adverse Childhood Events
65
Q

Family based RFs associated w/decreased school readiness

A 
Low maternal education
Single parent households
Low parental literacy
Household with few or no books
English second language
66
Q

School based RFs associated w/decreased school readiness

A

Schools that fail to recognize or accommodate special health problems, developmental needs, and cultural differences of incoming students

67
Q

Protective Factors for School Readiness

A

High maternal education level
Living with both parents
High parental involvement in education
Supportive student teacher relationships

68
Q

Red Flags For School Problems

A

Bullying
Toxic Stress
Mental Health Disorders
Media

69
Q

Effects of bullying:

A

Lower achievement, feeling unsafe, feeling as if one does not belong at school, and feeling sad were all positively associated with being a victim

70
Q

Signs of Bullying

A 
Insomnia
Sadness
Stomachaches
Headaches
Enuresis
Difficulty Concentrating
Symptoms of Anxiety or depression
High rates of school absence
71
Q

What is toxic stress? What causes it?

A

When a child experiences strong, frequent, and/or prolonged adversity without adequate adult support.
Physical or emotional abuse
Chronic neglect
Caregiver substance abuse or mental illness
Exposure to violence
Accumulated burdens of family economic hardship

72
Q

Consequences of toxic stress

A

Impaired educational achievement, economic productivity, health status, and longevity.
Anxiety
Impaired memory and mood control
Mental Health Conditions

(increased stress hormone alters brain architecture&raquo_space; linguistic & cognitive probs)

73
Q

Primary prevention of toxic stress

A

Routine anticipatory guidance that strengthen a family’s social supports
Encourage a parent’s adoption of positive parenting techniques
Facilitate a child’s emerging social, emotional, and language skills: Promotion of the 7Cs of resilience (competence, confidence, connectedness, character, contribution, coping, and control); Reach Out and Read

74
Q

Secondary prevention of toxic stress

A

Screening for developmental delays at 9, 18, and 24/36 months

Screening for risk factors for toxic stress:
Maternal depression
Parental substance abuse
Domestic or community violence
Food scarcity
Poor social connectedness
75
Q

In children transitioning to formal schooling, approximately___ in ____ (__%) will have a psychiatric disorder with impairment and may benefit from services

A

one in five (21.6%)

76
Q

Risk Factors for psych DOs with impairment

A

Poverty
Paternal depressive or anxiety symptoms
Childhood stressful life events
Exposure to violence

77
Q

Adverse effects of screen time

A 
Obesity
Inactivity
Attention Problems
Aggression
Sleep Problems
78
Q

In a study of children 15-48 mos, “Children who started watching television at 2 h/day were approximately ___ times more likely to have language delays.”

A

six

79
Q

AAP Recommendations on Media

A

No screen time for children less than 2
No more than 2 hours of screen time per day after two
TV off during mealtimes
No TVs in child’s room
Substitute TV time with reading, games, hands on time together

80
Q

Dimensions of Readiness

of the school itself

A

Goals of Early Education

School Systems

Classroom and teaching environment

APRN involvement

81
Q 
#1: Goals of early education
The “5 Rs” in the first 1000 days of life
A
  1. Reading together → daily fun family activity;
  2. Rhyming, playing, talking, singing, and cuddling together → throughout day;
  3. Routines and regular times for meals, play, and sleeping;
  4. Rewards for everyday successes → helping, cleaning etc.
  5. Relationships that are reciprocal, nurturing, purposeful, and enduring,
82
Q 
Readiness of school
#2: School Systems
A

NEGP (2010) outlined some characteristics of schools that support learning and development:

Sensitive to the needs of the child – “individualized learning”

Welcoming of parental involvement

Sensitive to cultural diversity and differences, including poverty, race, and disability

Help kids make the transition between home/childcare and school

83
Q 
Readiness of school
#3: Strong Classrooms
A

Teachers have knowledge of early child development

Small-group, child-led/ teacher-supported learning.

Lessons should be meaningful to the child

Hands-on activities

84
Q

What to look for in quality childcare/preschool

A

Small staff-to-child ratios and low staff turnover

Developmentally appropriate curriculum

Help ease the transition to kindergarten

affordability

85
Q

What is head start?

A

Enrollment based on federal poverty guidelines

Head Start mandates COMPREHENSIVE SERVICES to children and families - a unique feature of the program

86
Q

Services provided by head start

A

comprehensive

Health Services – physical health, oral health, mental health, nutrition and physical activity; prenatal care

Education Services, including Disabilities/Special education

Family Services thru Family Partnership Agreement, parent engagement and governance, fatherhood initiative, etc.

Community Partnerships

87
Q

APRN role in readiness of school

A

Consider school setting as a factor when children are frequently ill, fearful, anxious, and “inattentive or impulsive”

Know schools in the area (type of school, environment)
Ask parents about their experience with school
Maintain connections with school nurses, APRNs and school counselors

Refer to school for IEP and 504 plans

APRNs are welcomed in school settings (ex. PPT meetings) as advocates of the child

Ask questions and inquire about school at every WCC – Be proactive!

88
Q

Barriers to aprn role in readiness of school

A

Time consuming and requires intensive follow-up and coordination

Requires connections, contacts and relationships with school system

How to bill and get paid for these services?
Telephone codes, care plan coordination codes, case management codes
Reimbursement is unreliable, dependent on insurance and documentation

89
Q

Dimensions of support systems for school readiness

A

Family Characteristics
Community Systems
Special Populations
Children with Special Education Needs

90
Q

1 family characteristics

How can I help my child grow and develop and be a part of the family?

A

Parents as a child’s first teacher

Parental involvement in child’s development is crucial

Reading together
Rhyming games
Memory games
Cooking together

Sleep hygiene and routines

91
Q

2: Community Systems

A 
Prenatal care
Clean and healthy environment
Birth-to-Three
Access to high quality preschools
Youth programs
Local libraries
92
Q 
#3: Special Populations
LGBT parents
Undocumented/refugee families
Cultural and language barriers (ESL, immigrants)
Single parent households
Father involvement 
Talented and gifted students
And many more…

How do you assimilate all these diverse populations, backgrounds, experiences and biases into a standard public educational/healthcare framework?

A

You can’t. But the APRN should try and provide as much support as possible

Refer to community groups, forums where like-minded parents can share experiences.
Connect families to government-funded resources
TAG students – local groups, f/u with school for evaluation
ESL classes for immigrants

93
Q

4: Children with Special Education Needs

Who needs additional support in the classroom?

A 
Motor delays
Sensory delays
Intellectual delays
Chronic medical condition
 Diabetes
 Asthma
 Sickle cell disease
 Juvenile idiopathic arthritis
 Epilepsy
 And many more…
94
Q

What is IDEA? APRN Role

A

Individuals with Disabilities Education Act (IDEA) – “Special Ed”
IFSP (Individual Family Service Plan): for children birth to 3 years
IEP (Individual Education Plan): 3-21 years
Assessment by multidisciplinary team
IEP might include: tutoring, PT, OT, speech therapy

95
Q

What are 504 plans? APRN role

A

504 Plan: Section 504 of the Rehabilitation Act

Accommodations in regular classroom (eg: for ADHD, T1DM, allergies, etc)

APRNs can and should write letters to school for IEP and 504 plan referrals

SPRING16 N833 Adv Pedi (9 decks)

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