Observation while working with family is key
While a learning needs assessment for a child is not formal, it is important to determine how they can learn and how much they can learn, says Kathy Ordelt, RN-CPN, CRRN, patient and family education coordinator at Children’s Healthcare of Atlanta. The assessment takes place while working with the child and helps determine if the child’s developmental level fits his or her age so education can be tailored accordingly. “You approach a child at age 3 or 4 differently than at age 8 or 9,” says Ordelt.
While honesty is fitting when teaching children at any age, the information should be delivered in an age-appropriate, nonthreatening way. For example, young children often take statements literally so, instead of saying something will burn, it is more appropriate to say that it will feel warm. “You need to use words that will not produce fear so they aren’t superanxious at the start of a procedure,” says Ordelt.
Props, such as dolls, models, and picture books, also help when teaching children. She says children learn best in hands-on activities; therefore, she suggests that those working with children allow them to do medical play when preparing for a procedure. If a family is going to learn catheterization for a bladder program, give the child instruction with a catheter kit and a doll, Ordelt adds.
A health care professional can observe play to determine if the child is ready to handle the next step in his or her care.
When a child is the patient, health care professionals need to be able to instruct parents or guardians according to adult learning principles, and then work with the child at his or her developmental level. All five senses should be incorporated into lessons for children including smell, taste, touch, sights, and sounds. For example, let children know that something will feel cold or wet so they know what to expect.
Part of the hands-on teaching that also can serve to assess what children will be able to handle should include letting them help when preparing for a procedure, suggests Ordelt. For example, when nurses are doing a central line dressing change, they can ask the child if he or she would like to help gather the supplies. “Take those steps with the children to see how much they will be able to handle, and sometimes you [can] even involve siblings because they go through the crisis too when a brother or sister is ill,” she explains.
During the assessment process, a health care provider is not just trying to determine how much information to give a child, but when to give it. Preschoolers should be given information immediately before a procedure because they have no concrete sense of time, and will therefore become anxious. “Right before a procedure, teach them what it will be like,” says Ordelt.
Teenagers, on the other hand, want control and should be given information at least a week ahead of time so they can prepare for the event.
Children’s ages don’t necessarily indicate their developmental stage; therefore, it is important to determine what a child can do. Also determine if the family will give the child permission to participate, and if his or her involvement will work with the family dynamics, says Ordelt.
When a child is diagnosed with cancer or another devastating illness, clinicians work with the entire family. Therefore, it is important to assess the family system to know when to give information, how much to give, and when to give it, she explains.
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For more information about conducting a pediatric learning assessment, contact:
• Kathy Ordelt, RN-CPN, CRRN, Patient and Family Education Coordinator, Children’s Healthcare of Atlanta, 1600 Tullie Circle, Atlanta, GA 30329. Telephone: (404) 785-7839. Fax: (404) 785-7017. E-mail: [email protected].
While a learning needs assessment for a child is not formal, it is important to determine how they can learn and how much they can learn, says the patient and family education coordinator at Children’s Healthcare of Atlanta.
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