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MRCPCH Clinical: Development

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Assessment of Social development and interaction » Essays
Role: ST4 paediatrics. Setting: child development centre. You are talking to John and his mother Andrea. Task John is 5 years old. He was born at term by normal pregnancy and normal delivery. He had a normal neonatal period as well as early infancy. At the age of about 13 months his parents started having concerns regarding his development. They put this down to stress as his parents went through a divorce. His mother continued to have concerns. His class teacher is concerned about his interaction with other children and has referred him to you for an assessment. Please assess his social and interaction skills. Please take a few minutes to do this exercise before proceeding to the answer
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Social and interactive skills can be assessed by looking at:-


-A child’s behaviour when around others (smiling, eye contact, making friends and showing concern for them and their sibling).
-Behaviour during play (sharing with others, ability to take turns, playing with others, exploring the environment and different toys)
-Self care skills (mealtimes, dressing, undressing and toileting)


Introduce yourself to John and his mother and obtain consent.  Engage John in a conversation. Ask him about school and his  friends. Does he make eye contact? - Some children might be shy in the presence of a stranger so you might not get a true picture.


Try to play a game with him.  Assess his ability to engage, take turns and show concern.
 

Obtain information from his mother/John regarding:-

mealtimes-can he use cutlery?

toileting- is he toilet trained? Is he dry by day and by night?

dressing and undressing- Can he dress himself? Does he need help with his bottons?


Summarise your findings and present them to the examiner. Propose a management plan.  In this scenario, the mother might be worried that her son has autism. It is important that you state that the assessment of social and interaction skills can be greatly affected by a childs’ environment. You should therefore  propose as part of your management plan a full assessment by a trained team.

At 5 years you will expect John to:
Make eye contact with you – at least temporarily
Uses knife and fork
Chooses own friends
Dresses and undresses alone
Understand order
Protective towards younger sibling
Show concern towards others
Take turns in play
Engage in cooperative imaginative play and observe the rules.

 4 years
Washes and dries hands
Uses spoon and fork skilfully
Can dress and undress
Needs help with laces  and buttons
Constructive make-believe play


3years
Washes hands
Can pull pants down
Can be dry by night
Helps with daily activities
Plays with other children and understands sharing


21/2 years
Can use a fork
Can be dry during the day
Role play
Can join in to play with others


2years
Feeds confidently with a spoon
Puts on shoes
No understanding of danger
Can turn door handles
Tantrums to express frustration or need for attention
Does not share during play, parallel play