Development Red Flags case study essay
Case Study 1
A mother brings in her 16-month-old, Brittany, for treatment of an acute illness. During the history, the mother reports that her mother-in-law is concerned about the toddler’s development. Further questioning reveals the following:
Brittany was a term infant born vaginally with no intrapartum complications. Birth weight was 8 pounds 1 ounce and current weight is 26 pounds 9 ounces.
She was breastfed until 12 months of age and now drinks 24 ounces of whole milk and eats table foods daily.
Physical milestones are as follows: Rolled front to back at 6 months, developed pincer grasp at 11 months, crawled at 8 months, and began cruising at 10 months. She does not walk independently Development Red Flags case study essay.
Social development includes mimicking adult behavior, four-word vocabulary (mama, dada, baba, and no), follows one-step commands and quiets easily when comforted.
During these visits, patient growth and development are assessed. As an advanced practice nurse who performs these assessments, you must be able to distinguish between normal and abnormal growth and development to recognize red flags. While some patients may not meet milestones due to differences in rates of development, abnormal development might also be a red flag of an underlying problem. In this Discussion, you examine the following case studies and consider potential developmental red flags Development Red Flags case study essay.
Based on the information provided, Brittany’s cognitive, physical and social development has been on schedule. However, there are major red flags in her social and cognitive development. Brittany ought to be walking at 11-13 months. However, this is not a red flag until she reaches 18 months of age (Goodway, Ozmun & Gallahue, 2019). Brittany’s speech assessment should incorporate a comprehensive history from her parents, the provider’s physical assessment and observation Development Red Flags case study essay. Relevant questions to be asked when obtaining additional history include:
- What are the parental concerns on Brittany’s growth and development?
- Can Brittany lower herself from a standing to a sitting position without falling?
- Can Brittany pull herself to a standing position?
- Can she walk backward and forward with help?
- How do you talk to Brittany daily? Has she revealed any signs of hearing difficulty?
- Is Brittany able to drink from a cup? Development Red Flags case study essay
Besides, if Brittany has any potential delays in speech and other related developmental disorders, it will be vital to refer her to an audiologist.
Nurse practitioners should be knowledgeable of the normal growth and development of infants to be able to determine abnormal development. With this knowledge, nurse practitioners can help caregivers/parents to transform infants from reactive and dependent on a proactive and independent individual. Although developmental sequences are the same in most children, development milestones are potential markers that can be used to determine normal and abnormal development Development Red Flags case study essay.
An integral screening tool for childhood development is the Ages and Stages Questionnaire (ASQ). This screening tool has proven to be user-friendly, accurate and cost-effective (Singh, Yeh & Blanchard, 2017). Besides, it is the most recommended for early identification of autism and general development surveillance. Currently, existing evidence suggests that the ASQ is the most appropriate tool to conduct follow-up for infants born through assisted technologies for reproduction (Singh, Yeh & Blanchard, 2017). It is also the most recommended to conduct assessments of infants and children who were born prematurely or at high risk.
Whether Britany has additional concerns will be determined through an additional physical examination and screening. In case any abnormalities are detected, a speech-language therapist can be consulted for further management and follow-up. The clinical management of Brittany can further be guided by the clinical guidelines provided by the AAP (American Academy of Pediatrics), an organization that purposes to ensure optimal development of infants, children and adolescents physically, mentally, socially and emotionally.
If Brittany had not delayed her immunizations, according to the immunization schedule by the CDC, she would have rotavirus, PCV13, hepatitis B, MMR, DTaP, VAR, Hib and Hepatitis A (Strikas et al., 2015). The next immunization will be administered at 4-6 years as follows: varicella, DTaP, IPV, and MMR. The next wellness visit will be at 18 months Development Red Flags case study essay.
Goodway, J. D., Ozmun, J. C., & Gallahue, D. L. (2019). Understanding motor development: Infants, children, adolescents, adults. Jones & Bartlett Learning.
Strikas, R. A., Child, A. C. I. P., Group, A. I. W., & Advisory Committee on Immunization Practices. (2015). Advisory committee on immunization practices recommended immunization schedules for persons aged 0 through 18 years—the United States, 2015. MMWR. Morbidity and mortality weekly report, 64(4), 93.
Singh, A., Yeh, C. J., & Blanchard, S. B. (2017). Ages and stages questionnaire: a global screening scale. Boletín Médico Del Hospital Infantil de México (English Edition), 74(1), 5-12 Development Red Flags case study essay.