Health assessment practices and clinical applications

Health Assessment

The eight-year-old child -- developmental milestones and assessing a diabetic patient

Physical milestones

The eight-year-old begins to have a big appetite, and some experience rapid weight gain. Parents can help control weight gain by limiting sweets and starchy foods" (Keith, 2007: 1). This is especially critical for a child with diabetes, with a diet and/or medication and exercise schedule that must be strictly monitored. Parents and the child should be asked about the child's level of appetite and diet patterns during any health assessment, and the child's awareness of what is necessary to do to maintain his or her physical health should be noted, as well as the child's general state of health.

Gross motor skills

An eight-year-old's stamina should show a notable increase during this period of life, she or he should be able to run and swim farther than before (Destefanis & Firchow, 2007). As the child in question was only recently diagnosed for diabetes, however, the child may have experienced weakness due to changes in blood sugar levels, and may need time to catch up with his or her peers, as his or her treatment plan is tweaked. A diabetic with properly managed diabetes can still actively participate in sporting activities.

Fine motor skills

An eight-year-old child should have developed superior finger control and the capability of manipulating small objects like a pen or pencil with comparable or near-comparable dexterity to an adult (Destefanis & Firchow, 2007). The child should be able to manipulate a knife and fork, and throw a ball. The child's level of fine motor skills should also be assessed, to see if he or she is physically as well as intellectually competent to help test him or herself for blood sugar readings, and inject him or herself with insulin.

Language

The child should be able to converse at an almost adult level with a school-appropriate vocabulary, on age-appropriate subject like school, extracurricular activities, and what the child does for fun. The child should be able to read independently, show organized and logical thinking, and exhibit an interest in finding out why things occur (Destefanis & Firchow, 2007). The child should receive an explanation of his or her illness in age-appropriate terminology. The child of this age often has a strong desire to feel independent and competent, and while the dependence on insulin may be frustrating, showing the child how to administer his or her medication with adult supervision (using an orange or a doll) may be one important way to create a reinforcing sense of autonomy.

A child of this age is likely to be interested in understanding why things are right and wrong, and making the child understand that the diabetes is not a 'punishment' is important.

Social development

Children of this age have an intense need to feel a sense of belonging, including playing with others as part of a group. Eating and food issues will invariably arise at times. The child's different dietary needs may make him or her feel less a part of a group, and less like everyone else. Children of this age are often impatient and the child may need to learn patience, discipline, and self-control in a way that can be difficult around food (Keith 2007:1). Assessing the knowledge level of the child's peers may also be critical, as children this age may be very influenced by peer pressure and wonder why they cannot eat cake like their best friend.