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NRS 434 Developmental Assessment and the School-Aged Child

NRS 434 Developmental Assessment and the School-Aged Child

Growth is defined as the continuous changes in size in both internal and external aspects. On the other hand, development is defined as the continuous process of adaptation throughout an individual’s lifespan (Scharf, Scharf & Stroustrup, 2016). Development progresses in a systematic sequence; however, each child advances through the predictable stages within a specific timeframe. School-aged children include children aged 6 to 12 years old. This paper seeks to compare the physical assessments among school-aged children, explain the typical developmental stages of a 6-year-old, and apply Erickson’s developmental theory to assess the child.

Physical Assessmentsamong School-Aged Children

The physical assessment of a school-aged child involves a complete head-to-toe exam. The assessment begins with assessing the general state to note the child’s hygiene and grooming and any signs of neglect or abuse (Srinath et al., 2019). The second step is taking vital signs, but different blood pressure cuffs are used based on the child’s age. Anthropometric measurements are taken to assess nutritional status (Srinath et al., 2019). The head-to-toe exam is performed using the four techniques of inspection, palpation, percussion, and auscultation. Special screenings are performed, including Vision, Hearing, and Dental screening (Srinath et al., 2019). The vision screening is conducted using a Snellen’s chart to measure visual acuity. It also involves assessing for squint, strabismus, and nystagmus (Srinath et al., 2019). A hearing screening is conducted if the child presents with complaints of impaired hearing. In addition, a dental screening is done for all school-aged children to assess for common dental conditions such as tooth cavities and bleeding gums as well as shedding of primary teeth and eruption of secondary teeth.

The school-aged child’s physical assessment would be modified to correspond to the age and developmental stage by beginning with the least discomforting or painful procedures and concluding with the discomforting ones (Srinath et al., 2019). I would also assess the parts associated with the chief complaint last. For example, in a child presenting with abdominal pain, I will examine the abdomen last to foster cooperation. Besides, for children from 6-8 years, I will conduct the exam in the caregiver’s presence to ensure cooperation (Srinath et al., 2019). However, for the older child, above eight years, I will provide privacy and promote autonomy. Furthermore, I will provide privacy for the older child by uncovering only the body parts being assessed to avoid discomfort from the development of secondary sexual characteristics.

Typical Developmental Stages of 6-Year-Olds

Key physical developmental milestones include improved locomotor skills such as skipping, running, and jumping. The child should demonstrate strong hand-eye coordination, such as the ability to throw a ball at a target (Scharf et al., 2016). They begin losing the milk teeth, and permanent molars, medial and lateral incisors begin to erupt. Emotional development milestones include demonstrating self-control skills and maintaining emotional stability (Scharf et al., 2016). Cognitive developmental milestones include knowing their age, concept of time, particularly night, morning, and afternoon (Scharf et al., 2016). Most have about 2560 words and make comprehensible 6-7 word sentences. Besides, the child should associate words with their use (Scharf et al., 2016). Typical social developmental milestones include fear of the dark and big animals, sibling jealousy, exhibiting a sense of humor, and being peer-oriented.

Application of Erickson Theory in Developmental Assessment

A 6-year-old falls in the Industry versus Inferiority stage in the Erickson theory. In the Industry versus Inferiority stage, the child develops a sense of confidence by mastering tasks (Orenstein & Lewis, 2020). However, the sense of accomplishment can be offset by a sense of inferiority that arises from failing. I would apply the Erickson theory by assessing a child’s ability to perform tasks independently, such as homework and hygiene and grooming activities, and the ability to regulate social behavior (Orenstein & Lewis, 2020). Besides, I would give the child a task and ask them to do it independently. I would also assess whether the child develops a sense of inferiority, such as low self-esteem, when unable to perform the task.

I would offer explanations using simple and short sentences and inform the child of any painful procedures, to gain cooperation. I would also use polite, non-threatening language to relieve anxiety and promote cooperation (Srinath et al., 2019). Besides, I would ask the child to provide his demographic information and history of present illness to encourage a sense of autonomy. I would also inform the child of the assessment findings, any abnormalities found, and additional tests that will be required.


Growth and development are continuous from conception to death. The physical assessment of a school-aged child involves taking vital signs, anthropometric measurements, head-to-toe exam, visual, hearing, and dental screening. Assessment can be modified by beginning with the least painful procedures and assessing the systems associated with the complaints last. Developmental assessment of a 6-year-old entails assessing milestones in the motor, cognitive, emotional, and social aspects. The Erickson developmental theory can be applied to assess a child’s development by asking the school-aged child to independently perform a task and assess if they develop a sense of inferiority if they fail.


Orenstein, G. A., & Lewis, L. (2020). Erikson’s Stages of Psychosocial Development. In StatPearls [Internet]. StatPearls Publishing.

Scharf, R. J., Scharf, G. J., & Stroustrup, A. (2016). Developmental Milestones. Pediatrics in review37(1), 25. https://doi.org/10.1542/pir.2014-0103

Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for the assessment of children and adolescents. Indian journal of psychiatry61(Suppl 2), 158. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18



The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

1. Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.
2. Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
3. Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.

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Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.


Physical assessment of the child and that of an adult is done similarly yet differently. The act of auscultation, palpation, taking the vital signs to get the objective data are done the same but the normal range limits are different. For example, the healthy adult blood pressure normal range is from 90/60 mmHg – 120/80 mmHg, pulse rate 60-100 beats per minute and temperature of 97.8 ‘F to 98.6″F whereas to a 1-11-year-old child has a heart rate of 70-120 bpm, blood pressure of 90-110 systolic and 55-75 diastolic.

In using Erikson’s theory, an adult’s stage of development is focused on the fear of loneliness if there is no long-lasting relationship and adult contemplates their contribution to society with their achievements or lack of, and for a school-aged child, the focus is more on establishing trust and self-esteem (Grand Canyon University, 2018).

Communication and approach with these two different age groups also differ. A caring and comfortable environment is needed for a school-aged child in order to extend their trust from their parents to the healthcare provider. The questions are also formulated so that the child is able to answer. Whereas for the adult, a more factual and straightforward questioning is done. Utilizing the evidence-based practice tools provided to the health care team, a thorough and effective assessment is done to promote health and have an effective nursing process.



Grand Canyon University (Ed). (2018). Health assessment: Foundations for effective practice. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/


Medline Plus. Retrieved from: Vital signs: MedlinePlus Medical Encyclopedia


C.S.Mott Children’s Hospital .Retrieved from: Vital Signs in Children | CS Mott ChilVital Signs in Children | CS Mott Children’s Hospital | Michigan Medicinedren’s Hospital | Michigan Medicine



Child development assessment is defined as a process of getting data about their growth and development. The Nurse aims at getting a record growth in all areas while collecting the information. The data being collected include language, cognitive and social-emotional and approaches to learning. Child assessments is important in ascertaining children with special needs that may require extra support (Kaufman, 2018).

Comparing physical assessments of a child to an adult

Obtaining data is different at each age because human needs vary with age. In addition, the mode of assessment used is dynamic. For example, piece of information is obtained from the parent or care giver in a 5-year-old compared to the nineteen-year-old that can express themselves coherently. The Nurse uses Observation as one of the techniques used in the assessment. Here, the care provider interacts with the child and concludes based on their conduct. The other methods include standard test, portfolios, care provider ratings and parent ratings. However, all methods are best applicable for different ages. There is need to modify the techniques in some situation. For example, reading out questions on a standardized test for a five-year-old and writing out the answers for them. However, when the same approach is used on a twelve-year-old, they are left to read, interpret, and even answer the questions on the test with minimal assistance,

Communication strategies a nurse would use to encourage engagement

Nine-year-old Ben was born at 37 weeks with 2600grams via safe vaginal delivery and was admitted for 2 weeks due to birth asphyxia. He had gained 300grams on discharge. He was breastfed exclusively for the first 6 months and was weaned with different soft foods. He could roll over at 4 months and began sitting at 6. He was hospitalized for severe malnutrition for a month while he was 9 months old. This delayed his milestone and he only crawled when he was 16 months. He could say four-letter words at 6 months and could say complete simple sentences at 24 months. He has good relationship with his family members. He started school at 4 years, is obedient, has average performance, loved by teacher and friends at school. Ben fits into the 4th stage of Erikson developmental theory, known as Industry vs. Inferiority. The basic virtue at this stage is competency (Cherry, 2018). Based on Erikson`s theory, the nurse should focus on his ability to read, do simple sums, and write. The assessor will obtain information on Ben`s friends and this assessment done with he is with his friends. The friends he does not like will make him feel inferior.


Child development assessment is important because it provides opportunity for the care provider to establish any special needs that the child may require. Moreover, the assessment provides a ground where both the care provider and the parents can provide support for the child. However, the needs of the child change with time and hence the mechanisms used in assessing as well as the results (Kaufman, 2018).


Cherry, K. (2018). Erik Erikson`s Stages of Psychosocial Development. Retrieved June 5, 2018.

Kaufman, A. S. (2018). Contemporary intellectual assessment: Theories, tests, and issues. Guilford Publications.

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