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Using relevant theory, discuss the global development of a child, who you as a professional nursing student, have cared for during placement.

Using relevant theory, discuss the global development of a child, who you as a professional nursing student, have cared for during placement.

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An essay for the 2011 Undergraduate Awards (Ireland) Competition by Cheryl McCullough. Originally submitted for Nursing at Queen University Belfast, with lecturer Lorna Liggett in the category of Nursing
An essay for the 2011 Undergraduate Awards (Ireland) Competition by Cheryl McCullough. Originally submitted for Nursing at Queen University Belfast, with lecturer Lorna Liggett in the category of Nursing

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Published by: Undergraduate Awards on Aug 31, 2012
Copyright:Attribution Non-commercial

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02/05/2014

 
Child development begins before the child is born, at the time of conception,which “sets in motion powerful genetic forces that influence the individual over the entire lifespan” (Bee & Boyd, 2010, p.31). Keenan & Evans (2009)however, elaborate further by suggesting that it concentrates specifically onthe developmental period between conception and adolescence. Throughoutthis period there is rapid progression in each area of development including:biological (physical changes in size, strength and skill of the body), social(growth of relationships with other people), emotional (feelings about oneself and others) and cognitive (development of the mind, thought andunderstanding). The question of how these developmental changes occur hasbeen the centre of much debate, with many people favouring the role of nature and its genetic influences on development, versus that of nurture,where environmental influences and individual experiences impact ondevelopment. Despite the differing views, many agree that every aspect of achild’s development is the product of some pattern of interaction betweennature and nurture (Rutter, 2002), with different outcomes for each child, all of whom are unique, yet following universal predictable patterns of growth anddevelopment basic to all human beings. It is therefore important, in children’snursing practice, to have an understanding and an appreciation of normalranges of child development necessary for promoting optimal development,recognising and detecting developmental differences and planning theappropriate care to meet the holistic needs of the child (Sheridan, 2008).To demonstrate the importance of such understanding in children’snursing practice, this assignment will discuss the global development of a 12month old girl who was admitted to the ward and cared for during placement.1
 
She has been named Sophie for the purpose of this assignment, to upholdpatient confidentiality (NMC, 2008). She was born full term by normal vaginaldelivery, weighing 4lb 7oz and was diagnosed with a Ventricular Septal Defect(VSD). She has had a history of poor feeding from birth and now presentswith Failure to Thrive, or Faltering Growth as it is otherwise known. Applyingthis knowledge of her previous medical history and knowledge gained of childdevelopment theories, her current global development will be discussed,exploring each of the various areas of development.When considering her physical development it was important toremember her diagnosed Ventricular Septal Defect (VSD), which is the mostcommon congenital heart defect that occurs as a result of abnormalembryonic development (Chamley et al, 2009). This impacted her physicaldevelopment greatly as she had increased cardiac demands which affectedher energy levels and in turn her ability to feed and maintain weight gain.Despite having a larger intake of calories than required to meet her nutritionalneeds, her weight remained on the 0.4
th
Centile, leading to Failure to Thrive or Faltering Growth. According to Lissauer and Clayden (2007) these terms areused to describe a child who is failing to grow adequately, as a result of organic causes, associated with biological factors such as cardiac disease inthis case, or non-organic causes, associated with psychosocial andenvironmental deprivation e.g. in this case her mother had a poounderstanding of the baby’s nutritional needs and had not weaned hecorrectly, with much of her daily intake of calories being given via formula milkin her bottles, despite being one year old. Sophie’s mother should havestarted her eating solid foods from 6 months old (DOH, 2008) to help maintain2
 
her nutritional needs and promote weight gain, yet her heart condition alsocontributed organic causes, resulting in combined failure to thrive.Having explored her condition and the impact it had on her weight, itwas important to see the impact it had on the rest of her physicaldevelopment, also referred to as Motor development, and ascertain whether she was meeting her developmental milestones, which are normativeindicators showing general trends in children’s development worldwide(Meggitt, 2007). Such milestones are used to recognise both the abilities andneeds of children in relation to developmental differences. In exploring thesemilestones, the Denver II Developmental Screening Test (Frankenburg et al,1992) was performed as it has proved helpful in identifying many infants andtoddlers with developmental delay. It separates motor development into grossmotor development which involves large muscle movements e.g. sitting,crawling, weight bearing, and fine motor development which involvesmanipulative skills, using the arms and precise use of the hands and fingerse.g. pointing or using cutlery. At 12 months old, Sophie’s gross motor skillsshould have been developed so that she could rise to a sitting position fromlying or rise to standing without help, and remain standing unaided for a fewseconds, with some children able to walk by this stage. However this was notthe case and instead Sophie displayed the gross motor skills expected at 6months old, with her being able to roll over from supine to prone, use her shoulders to pull herself to sitting and sit for a few seconds unsupported. Her fine motor skills were similar in that they also showed some delay, but withinthis area of development she displayed skills similar to a 9 month old child,being able to pass toys from one hand to the other, bang toys together in her 3

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