24 chapter 4
Part of the art of examining a child is KNOWING WHEN TO STOP. It is important
to check everything that might help us understand the child’s needs. But it is equally
important to win the child’s confidence and friendship. Too much examining and
testing can push any child to the point of fear and anger. Some children reach their
limit long before others. So we must learn how much each child can take—and try to
examine the child in ways that she accepts.
Some children require a much more complete examination than others. For example:
Juan lost one hand in an accident 2 years
Ana is 2 years old and still does not sit by herself. She has strange
CP
ago, but otherwise seems normal. Probably
uncontrolled movements. She does not play with toys or respond
he will need little or no physical examination
much to her parents.
other than to see how he uses his arms,
stump, and hand. You will also want to
check how much he can do with his other
Ana seems to have many problems.
hand, with only his
stump, and when
using both together.
We will need to check:
• how well she sees and hears.
• how strong, weak, or stiff different
The Physical
Examination Form
parts of her body are.
• in what ways her development is
(RECORD SHEET 2
on p. 39) is probably
the only examination
slow (what she can do and not do).
• how much she understands.
• signs of brain damage, and how
form you need to
fill out.
severe.
• her sense of balance and position.
• what positioning or support gives her
However, it would be wise to learn about
better control and function.
now Juan’s family and others treat him now,
and how he feels about himself and his
ability to do things. Does he keep his stump
hidden when he is with strangers? With
family members? What are his hopes and
fears? You can write this information on the
It may take weeks or months of repeated examining and testing
to figure out all of Ana’s difficulties, and how to best help her to
function better . It could be a mistake to try to do all the needed
examining at one time.
back of the form.
To record all the useful information on a child like Ana, you will
find RECORD SHEETS 1, 2, 3, 4, and 6 helpful.
Examining techniques: Winning the child’s confidence
Depending on how you go about it, the physical examination can help you become a child’s
friend or turn you into his enemy. Here are a few suggestions:
• Dress as one of the people, not as
a professional. White uniforms often
scare a child—especially if at some
time he was injected by a nurse or
doctor.
• Before starting the examination, take
an interest in the child as a person.
Speak to him in a gentle, friendly way.
Help him relax. Touch him in ways
that show you are a friend.
• Approach the child from the same
height, not from above. (Try to have
your head at the same level as his.)
• Start the examination with the child
sitting or lying on mother’s lap, on
the floor, or wherever he feels most
safe and comfortable.
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