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Pediatric Nursing Approaches to Developmental Milestones

Pediatric nursing is a specialized field that goes beyond merely treating illnesses. It requires nurturing and guiding the development of young minds and bodies. To do so, nurses need a comprehensive understanding of child development.

The University of Texas at Arlington (UTA) online Master of Science in Nursing (MSN) in Pediatric Acute Care Nurse Practitioner (PNP-AC) program equips nurses with the skills and knowledge necessary to navigate this crucial aspect of pediatric care. Through courses like the Pediatric Assessment Lab, graduates practice conducting comprehensive pediatric health assessments and charting all developmental milestones or delays. The Pediatric Primary Care course introduces the health issues often presented in the outpatient setting and evidence-based early interventions.

Guiding Pediatric Development

All nurses should understand the nuances and necessary approaches to appropriately care for young people. While understanding available tools is one element of this, so is understanding the infant stages of development. In pediatric nursing, the BABIES mnemonic device is a helpful tool for remembering the infant stages of development:

  • B: Body changes
  • A: Achieving developmental milestones
  • B: Baby safety
  • I: Interventions
  • E: Eating plan
  • S: Social stimulation

These stages represent critical milestones in an infant’s development and offer valuable insights into their overall well-being and cognitive functioning. Nurses who keep these stages in mind can achieve better patient outcomes.

Monitoring Developmental Milestones

Pediatric nurse practitioners must also be well versed in the typical milestones past the infant stage. These milestones provide benchmarks for assessing a child’s development and identifying any areas of concern for early intervention. As the Centers for Disease and Prevention notes, “Reaching milestones at the typical age shows a child is developing as expected … Not reaching milestones or reaching them much later than children the same age can be the earliest indication that a child may have a developmental delay.”

According to a StatPearls article, “It is imperative for clinicians to develop familiarity with the normative dynamic process of maturation so that delays can be promptly identified. Responsiveness to intervention is most prominent in early childhood. The later the developmental aberration is identified, the more pronounced the risk becomes for developing emotional, social and academic dysfunction.”

Typical age-based milestones include:

  • 6 months: Rolls over, babbles and explores objects with hands
  • 9 months: Experiences separation anxiety, sits without support and plays peek-a-boo
  • 12 months: Stands, responds to simple commands and imitates gestures
  • 18 months: Walks independently, uses utensils and says several individual words
  • 2 years: Stands on tiptoes, uses two-word phrases and engages in parallel play
  • 3 years: Dresses self, copies others and stacks six or more blocks
  • 4 years: Plays with others, hops on one foot and knows some colors and numbers
  • 5 years: Understands differences between reality and pretend, tells stories and prints some letters and numbers

Addressing Developmental Delays

Developmental delays occur when a child fails to reach milestones within the expected time frame. As Cleveland Clinic notes, “Children reach milestones in playing, learning, speaking, behaving and moving …  at different rates. There’s no strict timetable.” Cleveland Clinic adds that approximately 17% of children have at least one developmental delay. While a child may be slightly behind, “a developmental delay means your child is continually behind in developing skills expected by a certain age.”

Early intervention is crucial in addressing these delays and promoting optimal development. UTA’s MSN in PNP-AC online program equips nursing professionals with the knowledge and skills to implement effective intervention strategies. The chosen interventions will vary based on the extent of the delay, such as whether it is isolated to one area of development or impacts several (resulting in a global developmental delay).

The following are examples of types of interventions:

  • Therapeutic: These include physical, occupational and speech therapy to address specific developmental delays.
  • Behavioral: Children may benefit from behavioral therapy, such as family and individual counseling, to address social and emotional difficulties.
  • Educational: Pediatric nurse practitioners may suggest partnering with schools and educators to establish individualized education plans (IEPs) for children with developmental delays.

Collaborative Approaches to Support Development

Family-centered care is an integral part of evaluating children’s development and growth. According to the American Academy of Pediatrics, “Developmental surveillance is family centered to promote conversations and trusting relationships wherein families can express concerns. Surveillance involves clinical judgment about when a child may be at risk for delays and when additional developmental screening might be warranted.”

UTA’s online MSN in PNP-AC program equips nursing professionals to use these and other effective pediatric best practices when considering developmental milestones. Since pediatric nurses are instrumental in guiding children through developmental milestones, they can monitor and support children’s optimal growth and well-being through thorough assessments, early interventions and family-centered care.

Learn more about UTA’s MSN in PNP-AC online program.

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