Monitoring and assessing of children

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In this part of my coursework I must describe two method of assessment that is carried out on a child from newborn, right up to the age of eight years old. I need to explain why they are important, give examples of each and state whether the examples of monitoring are effective or ineffective.

Monitoring and assessing a child is very important as these procedures can detect any abnormalities in a child and can also detect any life threatening diseases.

The two methods of assessment I have decided to analyse and describe comprehensively are screening and growth monitoring.

Screening

“Screening is a process used to identify apparently healthy children who may be at an increased risk of disease or condition” – (http://www.screening.nhs.uk/screening)

Immediately after every child is born, a number of routine checks are carried out on the newborn by health professionals before the baby is handed to the mother. Screening is a vital process as the purpose of is to observe the baby to see if it has any harmful or potentially fatal disorders that are not apparent at birth, or to see if the child has inherited any disorders from the parents. Screening takes place through the four life stages of a child which are from infancy, right through to school age, which is eight years old.

There are a number of different tests that carried out on a child. The three most common screening methods are;

* APGAR test

* PKU Test

* Ages and stages Questionnaire

APGAR Test

This test assesses babies’ health quickly, to detect if there are any abnormalities. The APGAR test was developed in 1952 by an anaesthesiologist called Dr. Virginia Apgar, who wanted a quick testing to be carried out on all babies in the crucial minutes after birth. Before this test was developed, health professions missed many internal problems at birth, such as circulatory or breathing difficulties. Most doctors over looked these internal problems as it was usually assumed that a newborn was healthy unless they were showing obvious signs of abnormality. (http://en.wikipedia.org/wiki/Apgar_score)

The APGAR test just simply takes between one and five minutes. Newborns will be examined to check their apgar score. Five elements are checked on a baby and are given a score of nought to two. If a babies APGAR test is scoring a seven, this means the newborn baby is healthy. If the score is under four, the newborn may require some resuscitation. The five elements a baby is checked on are; appearance, pulse, grimace, activity and respiration. These words form the acronym (APGAR).

For appearance, health professions need to observe that the skin is pink, if the skin is pink this shows that lungs are working well. The pulse is checked to see if the baby has a regular heartbeat. Grimace is the testing of facial contortion, example: when the baby cries the face will wrinkle and gurn in response to its crying pattern. If a baby is not doing this, this is a sign that something may be wrong. For activity doctors will be able to observe a babies health and muscle tone, if the arms and legs are flexed, the baby is healthy. Lastly respiration is tested to see if babies’ lungs are healthy or not.

This is what an APGAR test is, and how it is filled in.

This type of screening is effective as health professionals are carrying out this physical examination therefore they can detect if the infant has abnormalities or developmental problems straight away.

PKU Test

The short acronym PKU stands for a word called Phenylketonuria. It is a rare disorder that prevents a baby from metabolising a chemical called Phenylalanine, which is present in milk and other protein foods. A baby is tested for this condition by having the heel pricked to obtain a small sample of blood. This small sample of blood is then sent to a laboratory to see if the baby has the disorder. It is a very important type of screening that is tested in all children.

Ages and Stages Questionnaire

This method is also known as ASQ, this acronym stands for ages and stages questionnaire. This screening tool is a low cost, reliable way for parents and professionals to work together to screen infants and young children for abnormalities or development delays. This method screens for children from birth to five years of age. Parents or caregivers complete a 30-item list of questions at specified intervals for the first five years of their children’s lives. This type of developmental screening tool consists of many different questionnaires. For example; parents are questioned about their child on;

1. communication

2. gross motor skills

3. fine motor skills

4. problem solving

5. personal-social

These questionnaires are carried out over the first five years of a child’s live. Basically the questions target information that can flag and measure developmental delays or limitations in communication, motor skills, problem solving and social capabilities. This method of assessment only takes about 5-10 minutes for a parent to complete therefore it is not time consuming. From researching this method, I have acknowledged that this type of screening method is quite effective. “76% to 91% of parents agree that this method is very effective and reliable” – (http://earlychildhoodmichigan.org/articles/7-03/DevScrTools7-03.htm)

In my point of view, I believe that this method of assessment is quite ineffective as most parents want the best for their child. They don’t want their children to have abnormalities or disabilities, therefore as a parent is involved in this type of assessment they have the chance to deceive and lie in this method. For example a question on the questionnaire could be “is your child crawling?” If a parents child is not crawling they could probably lie and just simply tick yes for the answer as they may not want to admit that there could be something wrong with their child they want their child to be the best.

Health professionals just simply look through these questionnaires and if a parent has ticked ‘Yes’ for a majority of the questions, the health profession will have no concern, however on the other hand if some of the answers are ticked as ‘No’, this is a concern, therefore the health profession will be able to give the help that the child needs in order to develop properly, but if parents are lying through this method, Doctors will base the Childs development on this method and therefore no professional help will be given to the child if he/she needs it. Some may argue that it is an effective resource, but on my personal level, I believe it is ineffective.

Conclusion

In conclusion from the screening tools I have observed; I believe the most effective screening methods are the first two which are the APGAR Test and the PKU test. I personally believe these are the most effective as these test are carried out physically by health professions, whereas the third screening method; ages and stages questionnaire, the child is screened by the help of parents and as I have remarked before, parents can lie in this method and a child could need serious help and because the parent is lying, the child will not be able to receive the professional help that is needed.

Growth monitoring

Growth monitoring is a very important method that is that is carried out on all children. This method of assessment is the best general index to analyse, as growth can determine the health of a child. Growth monitoring is strongly supported by health professionals. Various measurements are used to assess growth. The main measurements that are taken from the child, is their weight, height and head circumference. These three aspects are measured regularly at different intervals and they are compared to all the different measures taken during the other intervals. With this information health professionals can detect if a child is healthy or has any developmental problems or disabilities.

Weight

Weight is the centrepiece which determines if a child is healthy or not. The weight of a child is recorded and it is compared to a growth chart which known as a Centile chart. It is a graph which consists of lines showing average measurements of weight, this type of chart can detect if a child is reaching the average weight or not. If a child isn’t meeting the average weight then some professional could help. For example; if an infant isn’t putting on any weight, then a health professional can subscribe a different type of milk formulation to help the baby put on weight. Being underweight can cause many complications when older, for example, if a child is underweight they can become anaemic; they could develop eating disorders etc. They could become bullied, self conscious of their bodies etc. It is extremely important that this aspect is monitored so that professionals can help. On the other hand being obese can also cause consequences, for example risk of heart disease etc, so it important that weight is detected and monitored in a child.

Height

Again height is extremely important as the recording of height can detect if the child has any disabilities or not. Height is also recorded on a Centile chart and it is taken regularly at different intervals of a child’s life to make sure the child isn’t suffering from any disabilities or abnormalities. For example; when I was an infant I had a dislocated hip. When my reflexes were tested I didn’t cry, but as my height was being recorded, health professionals detected that my height was below the average and at one stage I wasn’t growing.

Doctors decided to give me an overall examination containing scans etc. From this doctors could see that I had a dislocated hip and immediately solved this problem by putting a cast on me. If I hadn’t of got my height recorded, this problem would possibly have been overlooked and now, today I would probably suffer from stunted growth and have a disability as one of my legs would have be shorter than the other. Therefore this is the main reason why it is so important to keep a record of height, so that professional can detect abnormalities and action these problems as soon as possible.

Head Circumference

Head circumference is measured to make sure the skull is growing normally. If a baby’s head is bigger or smaller than the average or the head circumference stop increasing or increases quickly, this can detect that there is something wrong. For instance, a large head indicates that there is a large build up of fluid inside the brain which is dangerous. A head that is smaller than the average head circumference, this could be a sign that the brain is not developing properly or has stopped growing. This measurement is also taken and recorded on a Centile Chart.

Conclusion:

I believe Growth monitored is an effective method of assessment. The reason being is because every element that is tested and carried out on a child, it is done physically by a health professional, therefore these physical examinations will help doctors to detect if the child is healthy or not. I believe growth monitoring is the more effective method of assessment than screening because of the fact, that all checkups done within growth monitoring are done physically by health professional.

This is opposite to the screening method of assessment, as some of the tests are carried out on a child are physical examination and some aren’t as there are questionnaires involved which parent participate in and as I explained before, some parents may lie as they want their child to be the best, they don’t want health professionals telling them that their child has a disability, therefore from health professions taking their word from the parents on the child’s development, any serious abnormalities the child has, will be overlooked purely because the parent has lied.

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