Domain 13. Growth-development
Class 2. Development
Diagnostic Code: 00314
Nanda label: Delayed child development
Diagnostic focus: Development
Delayed child development, also known as delayed milestone attainment, is when a child fails to reach developmental milestones at the usual ages. It is considered to be a type of global developmental delay (GDD), and is often a sign of underlying medical conditions or disabilities. Early identification of these delays and proper interventions can improve the prognosis for the child. It is important for healthcare providers and parents to be know the general trends and scope of the problem, which includes recognizing signs of NANDA Nursing Diagnosis of Delayed Child Development and implementing needed actions for improving the child’s health.
NANDA Nursing Diagnosis Definition
NANDA nursing diagnosis of delayed child development is defined as a deficiency in the normal sequence of age-related milestones leading to impaired physical, cognitive, emotional, or social functioning. This diagnosis implies that some underlying factors, such as prematurity, genetic abnormality, environmental hazards, disease, or trauma, are present and contributing to the delay in development.
Defining Characteristics List
Subjective:
- Expressions of fear or apprehension regarding the future of the child
- Expressions of lack of confidence in the ability of the parents or caregivers to meet the needs of the child effectively
- Ineffective parenting techniques demonstrated
- Inappropriate expectations expressed by parents or caregivers regarding the overall growth rate of the child
Objective:
- Demonstrates significant defect in reaching age-appropriate developmental milestones
- Delays noted in language, gross motor skills, fine motor skills, and/or social/cognitive abilities
- Indicates decreased ability to comprehend instructions or remember information
- Actions reveal inappropriate relationships with peers and adults
- Genetic abnormality or mutations
- Perinatal acute illness or trauma
- Malnutrition
- Environmental hazards
Explanation: All of these factors may contribute to disruption of the child’s normal growth and development, leading to delays in acquiring age-appropriate skills and abilities. Prematurity and other illnesses during infancy, genetic abnormalities, malnutrition, and exposure to environmental hazards can interfere with the healthy development of a child’s brain and muscles.
At Risk Population
- Low birthweight infants
- Premature infants
- Infants with genetic abnormalities
- Infants exposed to environmental hazards
Explanation: Particularly vulnerable populations such as low birthweight infants, premature infants, infants with genetic abnormalities, or those exposed to environmental hazards are at greater risk for delayed development due to their weakened state. Thus, healthcare providers and parents should monitor these populations more closely for potential delays.
Associated Conditions
- Autism spectrum disorder
- Developmental disorders
- Mental retardation
- Cerebral Palsy
- Sensory integration disorder
Explanation:Delayed child development can sometimes be a sign of more serious medical conditions, such as autism spectrum disorder, developmental disorders, mental retardation, cerebral palsy, or sensory integration disorder. If a healthcare provider suspects any of these conditions, they may perform additional testing to confirm the diagnosis.
Suggested Use
The use of the NANDA nursing diagnosis of delayed child development is to inform healthcare providers of an underlying problem that may be affecting the health of the infant or child. This diagnosis can be used for both clinical and research purposes to help assess the current status and progress of a child’s development.
Suggested Alternative NANDA Nursing Diagnosis
- Feeding Difficulties
- Ineffective Coping
- Readiness for Enhanced Developmental Growth and Increase Knowledge
- Risk for Developing Delusions
- Risk for Impaired Attachment
Explanation:The aforementioned list of alternative NANDA nursing diagnoses can provide healthcare providers with additional assessment options for understanding the current status of the infant or child. Feeding difficulties may be a sign of delayed development if the child is unable to eat age-appropriate foods due to lack of coordination or concentration. Ineffective coping may manifest if the child is struggling with adjusting to new situations due to delays in development, requiring reassurance and guidance in order to master tasks. Knowing when a child is ready for enhanced development can help to ensure the appropriate level of care. Risk for developing delusions may arise in relation to interpreting one’s experiences, where the child gives too much credence to false ideas or stories, while risk for impaired attachment may arise if the child fails to adequately attach to appropriate caregiver figures.
Usage Tips
- Include developmental milestones and trends within the same age group during assessments
- Refer to specialist or allied health professionals if warranted
- Monitor risk factors as indicated if delays are noted
- Educate the parents or caregivers on factors contributing to delays
NOC Outcomes
- Cognitive Development: Reasoning/Quality
- Cognitive Development: Intelligence/Function
- Cognitive Development: Attention/Sustenance/Control
- Gross Motor Speech/Language
- Fine Motor Speech/Language
- Social Speech/Language
Explanation:These NOC outcomes are key indicators of the infant or child’s current status and development. They can be assessed through developmental screening tests and observing behaviors. Achieving these NOC outcomes indicates the likelihood of identifying, understanding, and intervening to promote a more favorable outcome in the developmentally-delayed individual.
Evaluation Objectives and Criteria
It is important to evaluate how the infant or child is progressing in order to determine if interventions are having the desired effect. Evaluation objectives and criteria should include:
- Percentage of the expected milestones achieved
- Observations on effectiveness of the interventions
- Changes in behaviors indicating increased abilities
- Improved interaction with peers and adults
NIC Interventions
- Cognitive Stimulation
- Execution Coaching
- Environmental Intervention
- Parent Education and Guidance
- Self-Care Assistance
Explanation:These NIC interventions can be used to help the infant or child develop skills and reach milestones at a faster rate. Cognitive stimulation activities provide cognitive challenge and opportunities to learn, execution coaching and environmental modification can foster behavioral change, parent education and guidance can provide support, and self-care assistance can help the child take ownership for their actions.
Nursing Activities
Nursing activities involved in addressing the delayed child development diagnosis span assessment of current development skills, implementation of pertinent interventions, frequent monitoring of progress, and provision of education and expertise to families of affected children. In addition, nurses must collaborate with other healthcare professionals to coordinate care and identify areas needing further action or adjustments.
Conclusion
Delayed child development can be distressing for both families and healthcare providers, yet identifying and properly acting on the diagnosis can make all the difference in the health outcome and quality of life of the infant or child. Proper observation and use of NANDA nursing diagnosis, related factors, associated conditions, evaluation objectives and criteria, and NIC interventions can help to diagnose and improve the prognosis of the delayed child.
FAQs
- What is delayed child development? Delayed child development is when a child fails to reach developmental milestones at the usual ages, and can be a sign of underlying medical conditions or disabilities. Early identification of these delays and proper interventions can improve the prognosis for the child.
- What populations are at risk of developing delayed child development? Particularly vulnerable populations such as low birthweight infants, premature infants, infants with genetic abnormalities, and those exposed to environmental hazards are all at greater risk for developing delays in development.
- What can healthcare providers do to address delayed child development? Healthcare providers can perform additional testing to confirm a diagnosis, use the NANDA nursing diagnosis to inform understanding of the current status and progress of a child’s development, refer to specialists or allied health professionals, monitor risk factors as indicated, and educate parents or caregivers.
- Are there any related conditions associated with delayed child development? Yes, related conditions such as autism spectrum disorder, developmental disorders, mental retardation, cerebral palsy, and sensory integration disorder may arise due to delayed child development.
- How can NIC interventions improve the prognosis of a delayed child? NIC interventions such as cognitive stimulation, execution coaching, environmental intervention, parent education and guidance, and self-care assistance can help the infant or child to develop skills and reach milestones at a faster rate, while collaborative efforts with other healthcare professionals can be beneficial in assessing areas needing further action or adjustments.
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