Risk for delayed child development

Domain 13. Growth-development
Class 2. Development
Diagnostic Code: 00305
Nanda label: Risk for delayed child development
Diagnostic focus: Development

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Introduction to Nursing Diagnosis Risk for Delayed Child Development

Delayed child development affects both the physical and psychological health of those affected. In medical terms, pediatric delayed child development is a developmental disorder that is typically diagnosed in children between the ages of four and six years old. It includes symptoms such as difficulty speaking, motor skills delays, and difficulty controlling attention and/or emotions. The diagnosis is typically made by a physician or other healthcare provider.

The National Association of Perinatal and Child Health (NAPCH) has developed a classification system for developmental delays such as this one: Milktooth Diagnosis Risk for Delayed Child Development (DRDC). According to the NAPCH, this diagnosis “refers to the risk that an individual is at for not reaching age-expected developmental milestones either in language, gross or fine motor, or socio-emotional domains.”

NANDA Nursing Diagnosis Definition

The NANDA Nursing Diagnosis definition for Risk for Delayed Child Development is as follows: Risk for delayed social/emotional/cognitive functioning related to lack of knowledge and/or stimulation. To assess if a child is at risk for delayed development, a careful history and evaluation of their current and past medical, developmental, and environmental risk factors is necessary. Additionally, a physical exam may be needed to rule out any underlying medical problems which could be impacting the child’s development.

Risk Factors

There are certain risk factors that can increase the likelihood that a child will experience developmental delays. These include:

• Genetic Factors: Certain genetic conditions and disorders can put a child at a higher risk for delayed child development.
• Environmental Factors: Environmental influences such as poverty, lack of access to proper nutrition, inadequate stimulation, and exposure to pollutants can all increase the risk of delayed development.
• Health Conditions and Prematurity: Certain health conditions like prematurity, intellectual disabilities, and autism spectrum disorder can put a child at a greater risk for development delays.
• Family History: A family history of developmental delays, especially when more than one family member is affected, can increase the risk of a child experiencing delays.

At Risk Populations

Certain populations are at a greater risk of experiencing delayed development than others. These populations are as follows:

• Babies Born Prematurely or with Low Birth Weight: Babies born before 37 weeks of gestation or with a low birth weight (less than 5 ½ pounds) often experience growth delays due to the impact of immaturity on the brain.
• Children with Medical Problems: Children with certain medical conditions like Down Syndrome, Fragile X Syndrome, Cerebral Palsy, or Spina Bifida often experience delays in their development due to the impact of the illness on their development.
• Children from Low Socio-economic Backgrounds: Children who grow up in poverty are more likely to experience delays in their development due to factors such as inadequate nutrition, lack of access to adequate healthcare, and lack of stimulation.
• Children with Developmental Disabilities: Children on the autism spectrum and those with other developmental disabilities are more likely to experience delays in their development as well as difficulties with speaking, communicating, and processing information.

Associated Conditions

In addition to the risk factors listed above, there are also certain associated conditions that can contribute to the diagnosis of Risk for Delayed Child Development. These include:

• Sensory Impairments: Visual, auditory, and tactile impairments can make it difficult for a child to learn and interact with their environment.
• Eating Disorders: Poor nutrition can have a direct impact on the growth and development of a child, leading to delays in physical, cognitive, and emotional growth.
• Neuromuscular Disorders: Neuromuscular disorders such as muscular dystrophy can limit a child’s ability to stay active, leading to delays in physical, cognitive, and emotional growth.
• Mental Illness: Mental illness such as anxiety or depression can interfere with a child’s ability to learn and interact with their environment, leading to delays in physical, cognitive, and emotional growth.

Suggestions of Use

If a child appears to be at risk for developmental delays, parents should consult with their medical team to discuss the best options for treatment. Treatment may include early intervention services such as physical, occupational, and speech therapy; changes to the child’s home environment; medications; and dietary modifications. Additionally, it is important that parents provide emotional support to the child and ensure they are given the opportunity to reach their full potential.

Suggested Alternative NANDA Nursing Diagnosis

In some cases, a healthcare provider may suggest an alternative NANDA Nursing Diagnosis for delayed child development. These diagnoses may include:

• Risk for Impaired Resilience: This diagnosis assesses the risk of the child not being able to bounce back from stress or challenging situations due to a lack of coping mechanisms.
• Risk for Cognitive Impairment: This diagnosis assesses the risk of the child not being able to keep up with age-appropriate cognitive skills due to conditions such as autism spectrum disorder.
• Risk for Injury: This diagnosis assesses the risk posed to the child due to his or her delayed development in areas such as mobility, decision-making, and safety skills.

Usage Tips

When evaluating a child for possible developmental delays, it is important to keep the following things in mind:

• Know Your Rights: Early intervention services are available to families and can be incredibly beneficial for a child at risk for delayed development. In the US, these services are provided for free or at a reduced cost through the Individuals With Disabilities Education Act (IDEA). Be sure to research your local early intervention programs and determine how to access these services.
• Well-Child Check-Ups: During a well-child check-up, your healthcare provider will assess your child’s development and growth. This is a great opportunity to discuss any concerns and ask questions about your child’s development.
• Trust Your Instincts: As a parent, you know your child best. If something does not seem right or if your child is not meeting age-appropriate milestones, let your healthcare provider know.
• Getting Help Is Nothing To Be Ashamed Of: It can be intimidating to get help for a child, but addressing developmental delays as soon as possible is key to ensuring that the child is able to reach their maximum potential.

NOC Outcomes

The NANDA Nursing Diagnosis of Risk for Delayed Child Development includes a list of outcomes, or the desired results when a child receives treatment. These outcomes are as follows:

• Gross Motor Functioning: This outcome assesses the child’s ability to control their body movements, such as walking, running, jumping, and climbing.
• Fine Motor Functioning: This outcome assesses the child’s ability to move their fingers and hands, such as picking up small objects, using scissors, and manipulating buttons or dials.
• Cognitive Development: This outcome assesses the child’s progress in learning to think, reason, make decisions, and solve problems.
• Socialization Skills: This outcome assesses the child’s ability to interact with others, including communicating with peers, expressing feelings, making friends, and being able to take turns.
• Emotional Development: This outcome assesses the child’s progress in understanding and managing their emotions, such as expressing anger appropriately or feeling comfortable with change.
• Self-Care Skills: This outcome assesses the child’s ability to take care of themselves, such as dressing independently, eating alone, brushing their teeth without assistance, and going to the bathroom without help.

Evaluation Objectives and Criteria

When evaluating a child for developmental delays, a healthcare provider will use a variety of methods and tests to assess their progress. These tests include:

• Gross Motor Functioning: This assessment consists of observing how the child moves and plays within the environment. The healthcare provider will also assess the child’s ability to hold objects, walk, run, stand, and other activities related to physical movement.
• Fine Motor Functioning: This assessment consists of observing how the child picks up and holds small objects and manipulates them with their fingers and hands.
• Cognitive Development: This assessment consists of observing how the child understands and processes language and how they perform simple problem-solving tasks.
• Socialization Skills: This assessment consists of observing how the child interacts with others and how they express their emotions.
• Emotional Development: This assessment consists of observing the child’s ability to regulate their emotions and respond to environmental triggers.
• Self-Care Skills: This assessment consists of observing the child’s ability to take care of themselves and do simple tasks such as getting dressed, eating, brushing their teeth, and using the toilet.

NIC Interventions

Once a diagnosis of Risk for Delayed Child Development has been made, the physician or other healthcare professional will typically recommend a number of interventions to help the child reach their maximum potential. These interventions are provided as part of the NIC Intervention Model and include:

• Fostering Appropriate Self-Help Skills: This intervention focuses on teaching the child age-appropriate activities such as feeding themselves, dressing, and buttoning clothing.
• Facilitating Motor Skills Acquisition: This intervention focuses on helping the child develop the strength, balance, and coordination needed to move around effectively.
• Encouraging Communication and Language Enhancement: This intervention focuses on helping the child understand language, articulate words, and use age-appropriate communication skills.
• Promoting Cognitive Development: This intervention focuses on helping the child understand abstract concepts, apply learned skills, and solve problems.
• Maximizing Functional Mobility: This intervention focuses on helping the child develop the necessary skills to move around safely, such as walking up and down stairs and crossing roads.
• Optimizing Socialization: This intervention focuses on helping the child understand and interact with others, such as recognizing facial expressions and taking turns.

Nursing Activities

Once the interventions have been identified and implemented, the nurse will then implement nursing activities to help the child reach their maximum potential and appropriately use their new skills. These activities include:

• Creating Diversionary Activities: This activity focuses on providing enjoyable ways for the child to practice and hone their skills, such as reading stories or playing music.
• Providing Health Teaching: This activity focuses on teaching the child, family, and other caregivers about the diagnosis and the importance of following through with the prescribed interventions.
• Facilitating Adaptive Behavior: This activity focuses on teaching the child the appropriate way to behave in various settings, such as home, school, and in public.
• Monitoring Progress: This activity focuses on regularly assessing the child’s development and adjust the plan of care based on their progress.

Conclusion

Risk for Delayed Child Development is a serious medical condition that can be difficult to diagnose and treat. Early intervention is key to ensuring that the child is able to reach their maximum potential. Therefore, it is important that parents pay close attention to their child’s development and make sure they have regular check-ups with their healthcare provider. If a concern arises, it is important to seek help as soon as possible to ensure the best outcome for the child.

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