MAJOR DIFFERENCES BETWEEN CHILDREN AND ADULTS. SPECIFIC APPROACHES AND TECHNIQUES TO PHYSICAL EXAM.

NORMAL FINDINGS, VARIATIONS AND COMMON PATHOLOGICAL CONDITIONS. INTERPRETATION OF EXAM RESULTS.

KNOWLEDGE OF GROWTH AND DEVELOPMENT. COMMUNICATION SKILLS WITH CHILDREN AND PARENTS. UNDERSTANDING OF FAMILY DYNAMICS AND PARENT CHILDREN RELATIONSHIPS. KNOWLEDGE OF HEALTH PROMOTION AND ANTICIPATORY GUIDANCE.

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HISTORY COLLECTION PHYSICAL EXAMINATION GROWTH AND DEVELOPMENT NUTRITIONAL STATUS

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PRESENT ILLNESS PAST HISTORY FAMILY HISTORY NUTRITION IMMUNIZATION

WEIGHT 3 YEARS 4 YEARS 5 YEARS HEIGHT 3 YEARS 4YEARS 5YEARS

12.5-16.5 Kg 13.5-19.5 Kg 15.4-21.4 Kg 90.5-101.5 cm 95-109 cm 103-115 cm

PULSE RATE 3 YEARS 4 YEARS 5 YEARS RESPIRATORY RATE 3 YEARS 4 YEARS 5 YEARS BLOOD PRESSURE 3 YEARS 4 YEARS 5 YEARS

105 +/- 15 beats/min 100 +/- 10 beats/min 95 +/- 15 beats/min

25 +/- 5 breaths/min 24 +/- 4 breaths/min 22 +/- 3 breaths/min

100 (+/- )24/67(+/-)25 100/66 +/- 20 100/60 +/- 14/10

            

GENERAL APPEARANCE HEAD NAILS FACE NECK EYES EARS NOSE MOUTH AND THROAT CHEST AND THORAX HEART ABDOMEN GENITALS

GROSS MOTOR DEVELOPMENT  Rides bicycle  Jumps from height  Hops on preferred foot  Skips using alternate feet  Walks, runs on tip toes  Walks straight line and backward  Runs without looking at feet  Kicks the ball  Balances on one foot for 3-5 seconds  Catches ball with extended arm  Tries to dance
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FINE MOTOR DEVELOPMENT  Places small pellets in narrow necked bottles  Can copy a circle, square, cross and diamond  Able to use scissors  Able to draw pictures  Can help with simple house hold tasks
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SELF CARE  Manages food with little spilling of food  Able to tie shoe lace  Knows back from front of clothes  Can go to toilet alone  Brushes teeth with assistance  May bathe self with assistance  Combs hair with help
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Establishes depth, perception and colour vision Can hear normally Develops sensory taste smell Enjoys stroking their bodies

Sense of initiative Vs. guilt ` Knows own sex ` Egocentric in thought and behavior ` Less dependent on parents but needs reassurance and help ` May have dreams and nightmares ` Physically and verbally aggressive

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Attempts to imitate adult behavior Develops imagination and creativity Feels guilty for their errors Spends much time and energy in purposeless activity Able to solve problems Jealous of siblings

PHALLIC STAGE ` More aware of their sex organs ` Attachment to parents of the opposite sex ` Feels aggression towards parents of the same sex ` Touching and manipulation of the genitals ` Ask simple question about sex ` After temporary parental separation, either feels happy or shows anger

INTUITIVE VS. PROJECTIVE FAITH ` Able to understand religion ` Learns about other religion also

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Rationalizes their actions Has social awareness Understands time Uses time oriented expression Understands space Understands conversation of size, shape and length.

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Moves from one idea to another and reaches a faulty conclusion Has mathematical thinking Understands others perspective Describes events Obeys parents set limits not because of understanding Highly imaginative

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Follows rules strictly Accepts changes in the rules

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Uses complete sentence with 3-4 words Talks regardless of whether anyone is paying attention Knows simple song Names colour Understands directions Gives full name Names figures and pictures Constantly asks questions

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Likes painting Plays with telephone Cooperative Fond of dramatic play Interested in stories

NUTRIENTS Energy needs Proteins Vitamin A Vitamin D Vitamin E Vitamin C Vitamin B1 Vitamin B2 Vitamin B6 Vitamin B12 Calcium Phosphorus Magnesium Iron Zinc Iodine

REQUIREMENT 1700 Kcal 30g 500 microgram 10 microgram 6 microgram 45microgram 0.9microgram 1.0microgram 1.3microgram 2.5microgram 800microgram 800microgram 200microgram 10microgram 10microgram 90 microgram

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CONCERNS OF THE CHILD PRESENCE OF PARENTS PREPARATION OF CHILD POSITION OF CHILD SEQUENCE OF DATA COLLECTION USEFUL DISTRACTIONS

PHYSICAL OR BIOLOGICAL DEVELOPMENT

AGE 6-8 YEARS 8-10 YEARS 10 YEARS 12 YEARS

WEIGHT 17.5-25.5 Kg 22-32 Kg 25.5-39.5 Kg Boys: 30-48 Kg Girls: 30-50 Kg

AGE 6-8 YEARS 8-10 YEARS 10 YEARS 12 YEARS

HEIGHT 110-124 cm 121.5-136.5 cm 131.5-147.5 cm Boys: 142-158 cm Girls: 144-160 cm

PULSE 6-8 YEARS 8-10 YEARS 10 YEARS 12 YEARS RESPIRATION 6-8 YEARS 8-10 YEARS 10-12 YEARS BLOOD PRESSURE 6-8 YEARS 8-10 YEARS 10 YEARS 12 YEARS

90 +/- 15 beats/min 85 +/- 10 beats/min 90 +/- 20 beats/min Boys: 90 +/- 20 beats/min Girls:85 +/- 20 beats/min 21 +/- 3 breaths/min 20 +/- 3 breaths/min 19 +/- 3 breaths/min

100/60(+/-)16/10mmHg 102/60(+/-)16/10mmHg 109/58(+/-)16/10mmHg 113/59(+/-)18/10mmHg

6-8 YEARS  Starts to lose temporary teeth  Acquires first permanent molars  Medical incisors, lateral incisors ` 10-12 YEARS  Acquires cuspids, first and second premolars
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GROSS MOTOR 6-8 YEARS ` Rides bicycle without training wheels ` Runs, lumps, climbs, hops ` Constantly in motion ` Clumsy and awkward ` Coordination improving

8-10 YEARS  Preforms tricks on bicycles, races  Begins to participate in organized sports like basket ball  Throws a ball skillfully 10-12 YEARS  Enjoys all physical activity

FINE MOTOR 6-8 YEARS  Knows right from left  Draws a person with 12-16 parts  Prints words; learns cursive writing  Has improved eye hand coordination 8-10 YEARS  Uses both hands independently  Draws a person with 18-20 parts  Prints fluently; cursive writing improved 10-12 YEARS  Coordination continues to improve

SELF CARE 6-8 YEARS  At 6 years, likes to eat with fingers, stuffs food into mouth, talkative while eating.  At 7 years, improved table manners, less talkative  Self care managed  Needs to be reminded to wash hands  Wears whatever is selected by the parents  Leaves clothes where they are removed  Can brush and comb hair

8-10YEARS  Handles eating utensils skillfully  Dresses self completely  Enjoys selecting own clothes  Needs to be remained to brush teeth 10-12YEARS  Criticizes table manners of parents  May wear same clothes continuously  Leave clothes where they fall  Enjoys wearing current style clothes  Needs constant reminding of personal hygiene  Bathes frequently, prefers shower

6-8 YEARS  Beginning of development of sense of industry vs. inferiority  Continues to be egocentric  Has a know it all attitude  Craves attention  Insists on being first in everything  Return of temper tantrums  Jealous of siblings  Fears to injury to body

8-10 YEARS  Is ready for anything  Curious about everything  Concerned about relationship with others  Becoming peer oriented  Easy to get along with at home  Begins hero worship  Considers peer opinions more important than parents  Enjoys helping mother in busy  Relationship with siblings improved

10-12 YEARS  Has greater self control  Respects parents and their role  Has short bursts of anger  Able to control anger  Hare worship of adults continues  Still fears the dark  Knows about sexual intercourse

LATENCY STAGE ` Becomes less egocentric ` Associate with same peers and tend to ignore the members of the opposite sex ` Girls associate with girls in their play

MYTHICAL LITERAL FAITH ` Children at this point may drop their religious affiliations or continue to accept the familys preference ` Children are learning many specifics about their religion that will develop into a religious philosophy to be used in their interpretation of the world

6-8 YEARS  Attention span increases  Can see differences more than similarities  Can tell time  Knows date, month and season  Is learning to read  Follows rules to avoid punishment  Takes small objects from others

8-10 YEARS  Learns to understand and use abstract symbols and carries out mental operations  Shows interest in casual relationship  Understands explanations and tries to follow through  Ashamed of failures  Interested in school work  Memory span increasing  Makes alibis for own faults

10-12 YEARS  Develops abstract and deductive reasoning  Uses problem solving method  Interested in the why and how  Begins to think about vocation  Preoccupied with right and wrong

6-8 YEARS  Commands  Response dependent on mood  Responds to praise and recognition 8-10 YEARS  Follows suggestions better than commands 10-12 YEARS  Follows suggestions better than requests

6-8 YEARS  Uses all forms of sentences  Develops a sense of humor  Enjoys telling jokes 8-10 YEARS  Is gregarious  Begins to use shorter and more compact sentences 10-12 YEARS  Able to give precise, dictionary definition of words  Enjoys riddles

6-8 YEARS  Loves active play  Prefers group play 8-10 YEARS  Prefers companionship in play  Hobbies begin to develop  Likes to compete 10-12 YEARS  Enjoys bicycle riding, reading, talking on phone, athletic sports, sex differences noticed in play

ANY CLARIFICATIONS