On this particular day, I had to manage a patient, 4 years old. The patient presented with inability to make average count of numbers with the parent seriously concerned that the children of his age were well past this stage. The patient, as observed by the parent was antisocial and prefers playing alone and has not been spotted even once having an idea of the ‘mom and dad’ play with other kids. On the other hand, the patient is said to have difficulties of separating from parents without giving a fight and cry. Top ascertain this, I requested the parent to walk out a bit so that I could offer the patient a fruit. Despite this enticing offer, the four year old patient declined and insisted on accompanying the parent outside the room. This was the point where I recognized that the patient had a serious case of mental development delay. The patient could also not use the toilet or dress appropriately as would be with other children of her age. The simple test to ascertain this was when I requested the patient to put on their shoes and she could not trace the right and left foot correctly until the parent assisted.
In this case, it is evident that the patient presented with delayed milestones which essentially implied a neurological condition that needed be addressed. It is surprising that the parents had realized for the first time despite having presented to the care provider on different occasions on which growth and development of the child was said to be okay. In this case, it was necessary to manage the fear and anxiety of the patient and to help develop a care plan that would assist the young patient reach at least some average level of development for her age (Jonovich & Alpert-Gillis, 2013). I however had to make an assessment of the family’s health history specifically on mental and behavioral issues which in this case were negative but the parent insinuated that the father to the patient had growth issues in childhood days which have since disappeared there were no records to show this but this was noted as leading information (Burns, Dunn, Brady, Starr, Blosser & Garzon, 2016).
I therefore advised the parent to avoid isolation of the patient from other kids and make sure that the child does not see any parent when interaction with other kids so as to develop a social understanding and an ability to relate with others (Burns, Dunn, Brady, Starr, Blosser & Garzon, 2016). On the other hand, more toys that were other mobile or those that could encourage some form of mental engagement should be available for the child when indoors to facilitate critical thinking. The parent was also advised to have on the need for a balanced diet for the child with foods that are filled with B6, B12, and folic acid (B9) which are crucial for brain development (Jarvis, 2015).
References
Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., Blosser, C. G., & Garzon, D. L. (2016). Pediatric primary care (5th ed.). Elsevier Health Sciences.
Jarvis, C. (2015). Physical examination & health assessment (7th ed.). St. Louis, MO: Saunders Elsevier.
Jonovich, S. J., & Alpert-Gillis, L. J. (2013). Impact of pediatric mental health screening on clinical discussion and referral for services. Clinical pediatrics, 0009922813511146.
