Chapter Nine: Tools for Promoting Good Health in Children

Health Policies For appraisals, screening, and assessment l Definitions  Appraisals = regular process of evaluation  Screening = to select or evaluate through a particular process  Assessment = in-depth appraisal to determine if a particular health or development condition exists

Important for observing, recording, and evaluating health l Early intervention to prevent problems and lessen impact

l Child caregiver is the primary health assessor l Daily contact l Communicates with parent l Participant observer

Policies needed for l Record keeping l Assessing a child’s health

Recording Health Status of Children Observation = primary means of data collection Record keeping management tools l Precise words l Type of records l Child care situation

Precise Words l Describe using adjectives that clearly explain what was observed  Mary has a rash. (Not precise)  Mary has a red, bumpy rash on her trunk and forearms that appears to be oozing. (Precise)

Types of Records l Anecdotal l Running record l Checklist l Time sampling l Event sampling

Child Care Situation l Child care center l Family child care l In-home/Nanny care

Assessing a Child’s Health Status l Daily quick health check l General health appraisal l Screening for growth and development norms l Mental health appraisal l Nutritional assessment

Daily Quick Health Check l Observe for  Severe coughing, sneezing  Activity level  Discharge from nose, eyes, and ears  Breathing difficulties  Sores Look, Listen  Swelling or bruising Feel, Smell  Unusual spots or rashes  General mood/unusual behavior  Skin color

General Health Appraisal l Used when warning signs of illness or health observed l Frequently recurring conditions l Seek the parent’s permission to contact health consultant l Child may be referred to physician

Screening for Growth and Developmental Norms l Weight and Height (failure to thrive) l Motor development (gross and fine motor skills) l Vision l Hearing l Speech and language l Mental health (At-risk indicators) l Nutritional intake and deficiencies

Implications for Caregivers Observation l What  Cultural differences  Is child at risk?  Does child have special needs?  Is there recent event that may affect behavior?

l How  Scientist = observe  Garbage collector = sort out feelings from data  Artist = use observation to take action and support the development and interests of child

l How also includes  Look, listen, feel, and smell l When  Quick check = daily at beginning  Ongoing  Monthly, quarterly, yearly

Education l Share information with parents l Caregiver has base of knowledge l Use health consultant l Referrals as necessary

Cultural Competence l Remember ESL may affect child’s norm  Check for native language l Any discussion should be sensitive l Dietary patterns are different  Seek knowledge of customs

l Supervision = carry out record keeping and assessments regularly l Establish communication system

Number One environmental threat l 5% of all children have levels that can cause cognitive deficiencies l African American and inner city children most likely to be affected l One in 6 children under the age of 6 years had lead poisoning  Inner cities - may be 1 of 2 children affected  Reality Check: Effects of Lead Poisoning

Effects l Mild to severe affects to  Nervous system, brain, growth  Cognitive deficits = inability to concentrate or learn  6 times more likely to have reading disabilities

Lead Poisoning knows no bounds l 74% of houses built before 1980 have lead based paint l Paint chips and dust are culprits  Children put things in their mouths  Play in dirt  Window seals

l Absorbed into bloodstream l Caregivers should  Provide diet that is rich with iron and calcium  Use frequent hand washing  Wash toys, floors, fruits, and veggies

l 4.1 million children under six years live in poverty l Almost 60% of single parent families with children live in poverty l Largest growing segment of homeless = families with children (1 in 3)  Reality Check: Poverty and Childhood

Poverty Can Result in Poor health l Decrease in blood iron levels—more dental, and vision problems, l Increase in lead levels—more frequent, more severe and longer lasting infectious diseases, emergency medical treatment, emotional and behavioral problems, more likely exposure to drug/alcohol abuse Lack of safety l Unsafe housing, unsafe neighborhoods, lead exposure

Poor nutrition l Basic needs may not be met, inadequate nutrition Effects of poor nutrition l School performance l Relationship of poor motor/mental development and anemia l School nutrition program supplements = positive effects

l Also contributes to emotional and behavioral problems

Caregivers can have a profound effect l Provide safe environment that screens for nutritional and health problems l Help families access resources l Offer emotional stability