How to Conduct the Assessment
Assessment techniques must be geared to the child’s developmental level and temperament. The traditional head-to-toe examination is usually not possible. Guidelines to alleviate fear and facilitate the exam in children are listed below.
For specific techniques and possible findings, see Section 2:Physical Assessment and Health Problems Across the Lifespan.
- Approach the child on eye level.
- If the child turns away from you, sit several feet away from the child and talk to the parent to allow the child time for adjustment. This is usually an ideal time to take the health history. Make all assessments possible before touching the child.
- If the child is in the parent’s lap, complete all assessments possible before moving the child to the examination table.
- Allow the child to touch or play with any safe equipment.
- Pretend to listen to the parent’s or older sibling’s heart or look into his or her ears.
- Explain all procedures in a soft voice.
- Use play whenever possible. Example: "Open your mouth like a big bear."
- Do not give a choice if there is none. Example: Say "I’m going to look in your ears," not "Would you let me look in your ears?"
- Save invasive procedures (such as looking into ears or mouth) and procedures that require clothing to be removed until the end of the exam.
- Allow the child or parent to remove the child’s clothing when necessary.
- Weigh the child under the age of 1 year without clothing.
- Praise the child for his or her efforts.