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Chapter 3
Assessing Children’s Health
©2015 Cengage Learning.
Health Information
• Information about a child’s health is
available in many forms and from a variety
of sources.
Health Information
• It can be used to:
assess and monitor a child’s health over time
identify developmental problems
formulate intervention plans
make referrals and work with service
– evaluate a child’s progress
Child Health Histories
• Information that families provide on health
history forms can be useful for
understanding the child’s:
– Current developmental progress
– Special health conditions or needs
– Daily habits and preferences, such as eating and
sleeping patterns and words used to express
personal needs
– Concept of family
Medical and Dental Records
• A complete physical form and immunization record are
required for admission to early childhood and public
school programs in most states.
• Height, weight and BMI measurements provide reliable
information about a child’s growth and well-being.
• Relatively quick, inexpensive, and efficient
• Some tests can be conducted by teachers,
• Others require the services of
professional clinicians.
• Designed only to identify children who may
have a condition that requires professional
evaluation, never to diagnose or confirm a
specific impairment.
Sensory System Assessment
• Young children learn primarily through their
sensory organs – eyes, ears, nose, hands,
and mouth.
• Teachers see children functioning in a
variety of situations and can observe
behaviors that may indicate a sensory
• What behaviors might suggest that an infant or
toddler may be experiencing a potential vision
problem? (See Teacher Checklist 3-1)
• What behaviors might indicate that an older child
may have impaired vision? (See Teacher Checklist
• What evaluation procedures can be used to
determine if a referral is necessary?
Identifying vision problems
– This is rather difficult until
a child is in school.
– A few tests are available
for the younger child
• Snellen Illiterate E
• Teller Acuity Cards
• Photo Screening
– Children often do not
know they have a
problem, because they do
not know what they are
looking at.
Common Vision Disorders
• Amblyopia – a distortion
and gradual loss of vision
due to a muscle imbalance.
– “lazy eye”
• Strabismus – a condition in
which the eyes appear
crossed or not aligned
– crossed eyes
• Myopia – nearsightedness;
child may appear clumsy
and ‘accident-prone’
• What behaviors might indicate a potential hearing
problem in an infant or toddler? (See Teacher Checklist 3-4)
• What behaviors might be observed in an older child?
(Teacher Checklist 3-3)
• What formal testing procedures are used to confirm or
rule out a hearing disorder?
Common Hearing Disorders
• Conductive loss – interferes with the ability to
hear and distinguish quiet sounds.
• Sensorineural and mixed hearing loss –
interfere with the child’s ability to hear and/or to
interpret sound.
Hearing Disorders
• What modifications and instructional
methods can teachers implement in the
classroom to help children who have a
hearing impairment?
Speech and Language
• Developmental milestones provide a functional
measure for evaluating a child’s speech and
language progress.
• A hearing test should be a first step in assessing
a child who may have a speech impairment or
• Referral for professional evaluation should be
made if there are any concerns.
Delayed language development or abnormal speech
patterns that persist for more than a few months should be
no speech by 2 years of age
substitution of word sounds
rate of speech that is too fast or unusually slow
monotone voice
no improvement in speech development
speech by age 3 that is difficult to understand
inattentive behavior or ignoring others
Height and Weight
• Measured at 4- to 6-month intervals
• Recorded in their permanent health file
• Measurements recorded on standardized
growth charts allow comparisons to be
made with previous data and can be
The WHO Child Growth
Nutritional Assessment
• BMI, appearance and behavior provide initial
indicators of a child’s nutritional well-being.
• Additional assessment tools include dietary/nutrient
analysis, measurements compared to norms (e.g.
BMI, head circumference), and laboratory tests.
Common Nutrition Disorders
• Malnutrition – a lack of sufficient food or
essential nutrients. May be caused by limited
access to food or unhealthy food choices.
• Obesity – commonly due to a combination of
excess food and calorie intake and inactive
Childhood Obesity
• In what ways does obesity
challenge children’s health?
• What can be done to avoid
obesity and improve children’s
weight management?
• A comprehensive evaluation may be needed to
identify a child’s health problem.
• The evaluation process must take the child’s
family and home environment into consideration.
• Teachers should refer families to appropriate
health professionals and support their efforts to
follow through with recommendations.
Case Study
A friend encouraged Mrs. Howard to take her son to the
developmental screening clinic being held this week at the
community recreation center. Parker is nearly 2 years old and
speaks only a few words that are understandable. He has few
opportunities to play with other children his age because he
spends most days with his grandmother while his mother works
at a nearby hospital. On the day of the developmental screening,
team members checked Parker's height, weight, vision, hearing,
speech, cognitive abilities, and motor skills. The team leader also
read through the child history form that Mrs. Howard had
completed and noted that Parker had several food allergies, as
well as frequent upper respiratory and ear infections. All of
Parker's screening results proved to be within normal limits, with
the exception of his hearing tests, which revealed a significant
loss in one ear and a moderate loss in the other.
Case Study Questions
1. Is Parker's speech development appropriate for his age?
2. What significance do Parker's ear infections have to his
hearing loss? How might his food allergies be contributing
to his hearing loss?
3. Should the screening team's recommendation for Parker
include a referral to his physician? Why?
4. What behavioral signs of hearing loss might you expect
Parker to exhibit?
5. What strategies might the developmental team suggest to
Parker's mother and grandmother for improving his speech
development and communication skills?