Nu 6541 Week 2 Case Study 3

NU 6541 WEEK 2 CASE STUDY 3 Case Study 3 In the given case, Jose is a 3-year-old presenting for a preschool evaluation. The patient’s father reports that Jose does physical activities such as walking, running, scribbling, walking up stairs alternating feet, jumping, and coping circles and squares. Jose can balance on one foot for 2 to 3 seconds. Jose’s reported social skills include recognizing 3 colors, speech which is 75% understandable, using 3 to 4-word sentences, talking about activities with friends and family, and engages in imitive play. Jose does have an imaginary friend. The father also reports that Jose will stutter on occasion when he is excited. He repeats the first word in a sentence 3 or 4 times but doesn’t repeat syllables or consonants. This paper will discuss potential developmental red flags regarding Jose and screening tools that can be used to measure this. Developmental Red Flags Jose does not have many developmental red flags presents. A child at 36 months of age is expected to copy circles, began imaginative play, and balance on one foot for 2 to 3 seconds (Burns, et al, 2017). Jose is also expected to use 3-word sentences and have a language that is 75% intelligible to strangers (Hagan, Shaw, & Duncan, 2017). Three-year-old children often stutter the first word of a sentence, especially when excited. This is usually temporary and subsides by the time they are five years old (Burns, et al, 2017). One red flag could be the walking up the stairs using alternating feet. This is a milestone accomplished at 30 months (Burns, et al, 2017). So further questioning would be needed to see when he accomplished this task. Another concern could be the imitative play. This milestone is accomplished at 30 months. By 36 months, the person is playing in cooperation and sharing (Hagan, Shaw, & Duncan, 2017). Screening Tools Many screening tools are available for providers to use to determine developmental delays in children. Questioning parents or caregivers regarding a child’s behavior can be a valuable tool to use when assessing developmental milestones. Questions are based on the child’s developmental milestones (Scheffer, et al, 2007). Some other screening tools are the Ages & Stages Questionnaires, Battelle Developmental Inventory, and Child Development Inventory. If a problem is identified using these screening tools, then further diagnostic tests are needed (Burns, et al, 2017). Questions should be asked to parents if they have concerns regarding their child’s developmental progression (Scheffer, et al, 2007). These concerns should be addressed. If concerns are present, referral to appropriate specialist may be necessary (Burns, et al, 2017). Conclusion Jose is a 36-month-old whose father provided knowledge about his developmental progression. From what the father provides, not much is concerning regarding Jose’s development socially and cognitively. Further questioning and screening is needed to determine if there are any major concerns. References: Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (Eds.). (2017). Pediatric primary care (6th ed.). St. Louis, Missouri: Elsevier. Hagan, J. F., Jr., Shaw, J. S., Duncan, P. M. (Eds.). (2017). Bright futures: Guidelines for health supervision of infants, children, and adolescents (4th ed.). Elk Grove Village, IL: American Academy of Pediatrics. Response to case 2- Cayla Darnell I agree that Brian is meeting his physical milestones but lacking in his social and cognitive development. By age 30 months, the patient should ask simple questions, follow commands, understand more reasoning, and understand prepositions (Burns, et al, 2017). His behavior could be concerning for autism. Brian could benefit from evaluation for this. Of course, other reasons for delays should be ruled out prior to this (Scheffer, et al, 2007). Parents should be encouraged to keep routines. A red flag in development at Brian’s age is beginning behavior issues and resistance to regular bedtime routines (Burns, et al, 2007). Suggestions for at home measures to curb this behavior should be implemented by the parents. The parents must understand that implementing changes can be hard for the patient and their selves, but the benefits on down the road will be worth it. Parents can often let things slide because it becomes difficult to control. Encouragement by the provider can help with this. References: Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (Eds.). (2017). Pediatric primary care (6th ed.). St. Louis, Missouri: Elsevier.