Early Childhood Development PDF

Individual Development - Early Childhood – Part 2 NURS 2510 Client & Context 1: Human Growth and Development Sufia Turner RN, MN, CCSNE Dayna Laviolette BSC., RN, MN Pawandeep Gill, RN MN Unless otherwise cited – all photos and images included have been created by the author, are stock photos, been...

Individual Development - Early Childhood – Part 2 NURS 2510 Client & Context 1: Human Growth and Development Sufia Turner RN, MN, CCSNE Dayna Laviolette BSC., RN, MN Pawandeep Gill, RN MN Unless otherwise cited – all photos and images included have been created by the author, are stock photos, been given permission to use or by unknown authors and licensed under Creative Commons BY-SA) At the end of this class, students will be able to: 1. Describe physiological, cognitive, and psychosocial developments in early childhood 2. Examine how knowledge of physiological, cognitive, and psychosocial developments can guide nursing care of a child in the stage of early childhood 3. Utilize applicable theories related to early childhood development. 4. Discuss language develop in the preschool years 5. Explore the relationship between social relationships, play and parenting styles to the cognitive and psychosocial development in early childhood. Age of Early Childhood: 2-6 years (Lifespan Development) Topics and/or exemplars: Autism Spectrum disorder, Tourette Syndrome and Obsessive compulsive disorder social-cognitive theory assumes that social and emotional changes in the child are the result of, or at least are facilitated by, the enormous growth in cognitive abilities that happens during the preschool years, especially in the domains of metacognition and theory of mind Disorders Diagnosed In Early Childhood There are some notable disorders that may be discovered Often noticed first by a parent – initiates care Possibly discovered in well child check up Nursing care directed at: Parent support Appropriate referral to services/supports/allied health or other clinicians Effective communication and documentation Autism Spectrum DisorderCharacteristics ASDs are complex neurodevelopmental disorders of unknown etiology. Characterized by deficits in social interactions and communication, unusual behaviours (e.g. Fixed interests, inflexibility, repetitive behaviours and/or unusual sensory responses). Common core deficits are noted primarily in social interactions. (e.g., abnormal eye contact, decreased response to own name, decreased imitation). Failure of social interaction and communication development is one of the hallmarks of ASD. Autism regression = normal development followed by sudden regression frequently displayed in expressive language. Providing a structured routine for the child is critical. Nursing Care Management If hospitalized, parents are essential to planning care and, ideally, should be present as much as possible. Decreasing stimulation by using a private room, avoiding extraneous auditory and visual distractions, and encouraging the parents to bring in possessions the child is attached to may lessen the disruptiveness of hospitalization. Children with ASD must be introduced slowly to new situations, with visits with staff caregivers kept short whenever possible. Any child who does not display language skills such as babbling or gesturing by 12 months old, single words by 16 months old, and two-word phrases by 24 months old is recommended for hearing and language evaluation. Next Steps in Care Assessment of communication by a registered speech and language pathologist Mental health providers assess family dynamics, ability to cope, how dynamics can contribute to symptom aggravation and evaluate for co-existing disorders (e.g ADHD) Physician for any underlying medical issue and, Occupational therapists assess for tactile sensitivities and challenges in daily living (e.g dressing, eating and bathing) A complex TIC disorder characterized by multiform, involuntary motor and vocal tics. (Tourette Syndrome Foundation of Canada, 2006). Chronic Tourette Syndrome Genetically transferred Neurological OR neurochemical No diagnostic test Criteria include the presence of more than 2 motor tics and 1 or more “phonic” tics Nursing Care and Management Ex. Limb jerking, frowning, abdominal tensing, lip pouting. Sucking sounds, barking, coughing or grunting. Nurse’s role is to document parents’ description of child’s behaviour including type of tic(s), duration in months, times per day demonstrated and any other symptoms are present “Automatic Suppression” automatic suppression" refers to the unconscious or subconscious control of tics. Family support normal intelligence Tics are worst during puberty and lessen over time Next Steps in Care Tourette Syndrome is chronic but not degenerative Referrals – neuro, OT, SLP Treatments – meds., cognitive behavioural therapy, psychotherapy Obsessive Compulsive Disorder (OCD) 50% diagnosed in childhood-adolescence 2/3 of children who have TS also have OCD Includes “rituals” or “compulsions” e.g step back and forth three time before crossing a doorway and “obsessions” e.g unwanted, intrusive thoughts Characteristics include: Checking, counting, hand washing, symmetry or exactness, collecting and “looping” or “being stuck” Can make children appear defensive, negative or “needy” Nursing Care and Management Families of pediatric patients with OCD may have high levels of anxiety. Can create a vicious cycle and exacerbate the child’s condition. Nursing role is to perform history and physical including: Parents account of concerning behaviour Any other co-morbidities including TS, ASD or mental health disorder in families and child Developmental delays observable or noted by caregivers or teachers Our next discussion in class will touch on trauma, neglect, and child abuse. This content can be difficult, so I encourage you to prepare yourself emotionally beforehand. If you believe that you will find the discussion to be traumatizing, you may choose not to participate in the discussion or to leave the classroom. We will have a break before this content to allow you to leave if needed. You will still, however, be responsible for material that you miss, so if you leave the room for a significant time, please arrange to get notes from another student or see your instructor individually. Adverse Childhood Experiences (ACEs) Patterns of Adversity Risk Factors Neglect (34%) Sociocultural Factors Exposure to intimate partner violence (34%) Characteristics of the Child Physical abuse (20%) Characteristics of the Abuser Emotional maltreatment (9%) Household Stressors Sexual abuse (3%) "Childhood stressors, ranging from day-to-day maltreatment of traumatic events, that increase the risk of wide-ranging, negative health and social consequences over the life course" One useful model for explaining ACEs classifies its causes into four broad categories: sociocultural factors, characteristics of the child, characteristics of the abuser, and household stresses Neglect Can lead to physical and chemical disruptions in the brain that can last a lifetime Associated with wider range of damage than active abuse but receives less public attention, policy or practice Neglect can disrupt emotions, cognition and behaviour Significant risk for emotional and interpersonal difficulties Significant risk for learning difficulties, poor school achievement From Harvard Center on the Developing Child https://developingchild.harvard.edu/science/deep-dives/neglect/ Nursing Intervention Intervention needs to be appropriate and timely to reverse or reduce the negative consequences Merely removing a child from neglect does not guarantee positive outcomes Therapeutic intervention and highly supportive care is needed to mitigate adverse effects and assist with recovery Children in these environments need to have their safety, control and predictability restored From Harvard Center on the Developing Child https://developingchild.harvard.edu/science/deep-dives/neglect/ We will introduce you to the assessment of abuse and neglect, but it is a skill that develops over time. Next Steps At this beginning stage of your professional development, it is helpful to know the signs and symptoms to look for Nurses can support each other in these circumstances and seek help from management for reporting pathways No single factor contributes, but rather the presence of multiple variables increases chances Adverse Childhood Experiences (ACEs) Outcomes Exposure effect: the degree of intensity and duration of a stressor is related to the intensity of the response Toxic stress response: persistently elevated physiological arousal caused by strong, recurring, and/or unabated adversity Prevention Begins with EDUCATION Identification of at-risk families Vigorous enforcement of existing child abuse laws Reporting of abuse is MANDATORY in all provinces and territories You will not be tested on this content Hockenberry et al., 2019 p 453 You will not be tested on this content Hockenberry et al., 2019 p 453 You will not be tested on this content Hockenberry et al., 2019 p 453 Emotional Abuse and Neglect You will not be tested on this content Hockenberry et al., 2019 p 453 Physical Abuse You will not be tested on this content Sexual Abuse You will not be tested on this content Early Childhood Activity In Class Activity: TV Show Critique In your assigned groups Watch the TV show that is associated to your group number. These are located on UMLearn - Early Childhood – In Class Activity Add your Full Name and Group Number to the assignment 1. Provide Pros related to the TV show for physical, cognitive and psychosocial development (with rationale, in full sentences) 2. Provide Cons related to the TV show for physical, cognitive and psychosocial development (with rationale, in full sentences) References Boyd, D., Johnson, P. and Bee, H. (2021). Lifespan Development (7th Canadian Edition). Toronto: Pearson. Hockenberry, M. J., & Wilson, D. (2018). Wong's Nursing Care of Infants and Children (11th Edition). Elsevier Health Sciences (US).