I'm on my paeds placement and was seeing a 10yr old girl with fairly severe developmental delay. When assessing these sort of patients it is very important in gaining a detailed history of the child since birth. This includes birth Hx (age, weight, complications etc...), developmental milestones, any injuries/conditions or events that have existed since birth until now.
The child attended with her mother and so I directed the subjective towards her while the child was playing. When I asked the mother about the latter question she began to tell me about how her and her child were victims of domestic violence and had previously been on the run from her ex-husband and still felt scared occasionally. On arrival I noticed how close the mother and daughter was and even when I told the daughter that she could go and play with the toys in the room while I asked the mother a few questions she was still apprehensive in leaving her mother. When I asked the mother she told me how now her daughter is still fairly scared and nervous when she meets new older males as they remind her of her father.
So after my subjective I kind of thought I would dedicate the first half of the session to getting close to the child and trying to make her feel comfortable around me. I did this by playing many games with the child and really joining in with her and making her feel safe around me. On reflection I think this was the correct thing to do based on her history as by the end of the session I believe she was a lot more confident around me and felt safe in my presence. Even though I didnt achieve as much in this initial sesssion as I usually would I booked her in for another session a week later where I plan to complete the assessment and then really get stuck into the treatment.
So what does everyone think about how I handled the situation and if anyone has been in the same situation how did they handle it.
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2 comments:
I think you have handled the situation the best way possible. Your Rx is only going to be effective from the outset if you have developed a good rapport with your patient regardless of their age.
It is essential in the paeds setting to also gain the respect of the mother. I am sure you would have done this after your intervention with the said child.
Your next appointment with the child may see you needing to re-establish the rapport and trust again but it should'nt take as long as the first time.
A reminder to the child that you will see them again may help the child deal with you on their next appointment.
Hey leigh! I think you handled that situation perfectly. That was alot of information to learn, I would have been quite freaked out by it. The way you went about it would have earnt both the child's and mother's respect. Well done!
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