THE PEDIATRIC PATIENT.pdf

The Pediatric Patient PEDIATRIC TREATMENT TRIANGLE Psychological Development of a Child SOCIETY Acceptable to society Jean Piaget - Children must be given learning tasks appropriate Litigiousness of the society to their level of de...

The Pediatric Patient PEDIATRIC TREATMENT TRIANGLE Psychological Development of a Child SOCIETY Acceptable to society Jean Piaget - Children must be given learning tasks appropriate Litigiousness of the society to their level of development. Lev Vygotsky - Children should be given the opportunity for frequent social interaction. Social contact is essential to intellectual development. Erik Erikson - Parents & other caregivers must be aware of, and sensitive to, children's needs at each stage of development and support them through crises. B.F. Skinner - Parents and other caregivers can affect a child's behavior through the use of negative and positive feedback. Albert Bandura - Caregivers must provide good examples for children to follow. Urie Bronfenbrenner - Child's primary relationship with a Litigious - prone to engage in lawsuits caregiver needs to be stable, loving, and lasting. Environment affects development. Classification of Child Development Arnold Gesell - Development genetically determined by universal "maturation patterns" which occur in a predictable sequence. GROWTH PROPORTIONS PSYCHOLOGICAL CHILD DEVELOPMENT THEORIES Sigmund Freud: Psychosexual Stage Erik Erikson: Psychosocial Development Jean Piaget: Cognitive Development Freud's Psychosexual Stages Oral Stage: Birth to 1 Year Erogenous Zone: Mouth feeding very limited cooperation CHRONOLOGIC AGE minimal language comprehension *child get info from its surrounding *everything they touch, they out in their mouth Anal Stage: 1 to 3 Year Erogenous Zone: Bowel and Bladder Control toilet training period child develops control over his bodily functions *potty training *child can control peeing and pooping GROWTH SPURTS - Sudden increase in growth of general body Phallic Stage: 3 to 6 Year birth to 2 years old Infancy Erogenous Zone: Genitals 3 to 8 years old Preschool early schooling 9 to 11 years old Pre-pubertal "Oedipus Complex"- The attachment of the child to the parent of 12 to 18 years old Puberty the opposite sex, accompanied by envious and aggressive feelings toward the parent of the same sex. SAPNU, NICOLE MAE R.  *they become curious, malice role-playing *you can already teach the proper etiquette egocentric - it is what it is *this phase where you can make utos to the child Latent Stage: 6 to Puberty Libido Inactive Concrete Operational Stage 7 to 11 yrs capable of reasoning logical thinking focused on other activities such as school, friends, and hobbies understand concrete events and analogies developing social skills and self-confidence. can perform mathematical equations *aware to what to tell and what to not tell Genital Stage: Puberty to Death *you know what is right and wrong Maturing Sexual Interests romantic relationships Formal Operational Stage nu 12 and up multiple forms of logical thinking deductive and inductive thinking generate and test hypotheses Personality Characteristics related to specific age 0 to 1 yo: - Separation Anxiety 1yo to 3 yo: - Sense of Autonomy - "NO" - Egocentric - Ownership *they start grabbing 3 yo: - People Pleaser - Less egocentric - Imaginative 4 yo to 5 yo: - Socializing - Active - Great Talkers - "THANK YOU" - "PLEASE" - Creative - Role-playing Piaget's Stages of Cognitive Development - Take pride in their possessions * Cognitive development - how children think, explore and figure things out. 6 yo to 8 40: - School Age Sensorimotor Stage - Independence Birth to 2 yrs experience through senses and motor activity 8 yo to 12 yo: " Stranger anxiety” - Responds well to explanations - Self-conscious Preoperational stage 2 to 7 yrs 12 yo to 18 yo (adolescent): language explosion - Self-absorbed - Adult language associate words and images - Self-discovery SAPNU, NICOLE MAE R. Behavior of Children in Dental Environment 3 main areas of child behavior in the dental office Classification of Behavior Forms of Behavior Factors which Affect Behavior C. Frank's Classification Classification of Behavior F4 F3 F2 F1 A. Child Temperament B. Visual Analogue Scale (VAS) F4 C. Frank's Classification ++ Definitely positive A. Child Temperament Easy Temperament Child Good rapport with dentist Difficult Temperament Child Laughter Slow to warm-up Temperament Child Enjoyment nterested in dental procedure Easy Temperament Child Unique behavior Positive mood Regular body functions F3 Adaptable + Positive approach to changes Positive Flexible enough to handle a quick change in plan Acceptance of treatment Cautious Difficult Temperament Child Willingness to comply Irritable Follows instructions with reservations Intense Irregular body functions F2 Difficult in adapting to neh situations and changes Negative Tends to withdraw in social setting Reluctant Respond best to a dentist who provides a great deal of structure Uncooperative in a sensitive but confident manner Some evidence of negative attitude but not pronounced (sullen, withdrawn) Slow to warm-up Temperament Child Shy F1 Low activity level -- Slower to adapt to new situations but once comfortable they begin Definitely negative to engage Refusal of treatment longer time to adjust, best served by dental personnel who are Forceful crying calm, patient and encouraging (w/o being demanding) Fearfulness Extreme negativism B. Visual Analogue Scale (VAS) Measurement instrument that tries to measure a characteristic or Forms of Behavior attitude that is believed to range across a continuum of values I and A. Cooperative Ability cannot easily be directly measured. It is the most effective with B. Lacking in Cooperative Ability young children, with "very cooperative" and "uncooperative" as the C. Potentially Cooperative clinical endpoints. A. Cooperative Ability Relaxed Tell-show-do Minimal apprehensions Enthusiastic Straightforward approach Behavior-shaping SAPNU, NICOLE MAE R. B. Lacking in Cooperative Ability Very young children No communication intellectual impairment Pharmacologic management Body restraints C. Potentially Cooperative Extreme high anxiety due to past experience or age-related apprehension Special attention Treatment time Pharmaco-therapeutic approach Uncontrolled Behavior Challenging or Defiant Behavior Timid Behavior Tense-cooperative Behavior Crying and Whining Behavior Passive Resistance Factors which Affect Behavior Anxiety Fear Generalized response Known external to an unknown threat VS danger or threat or internal conflict Mother's Anxiety Anxiety fear Past Medical / Need for Dental Treatment History SAPNU, NICOLE MAE R.