Developmental Differences in Children You Should Know for the EMT Exam

By Arthur Hsieh

You will need to know developmental differences for children for the EMT exam. From the time they are born until they transition to adulthood, children experience rapid physical growth. How they engage with their environment and other humans also changes dramatically. Children can be broadly divided into the following subgroups:

  • Infants: Birth to 1 year

  • Toddlers: 1 to 3 years

  • Preschool: 3 to 5 years

  • School age: 6 to 12 years

  • Adolescent: 13 to 18 years

Check out the developmental differences among the groups, as well as their impact upon your assessment and treatment approach.

Kids cry when they’re hurt or frightened; this is normal. You should be concerned about a child who is unusually quiet or cries weakly during your assessment and care.

Age Group Developmental Behaviors Assessment and Treatment
Infants Easy to separate from caregiver (separation anxiety develops as
infant approaches 1 year)
Crying a major form of communication, as is touch
Well-developed sense of hearing
Tracks motion with eyes
Being undressed normal, but staying warm is important
If possible, have caregiver hold infant during
assessment.
Evaluate appearance, work of breathing, and skin color (pediatric
assessment triangle, or PAT.
Find pulse at brachial artery.
Uncover body as needed but cover back up to preserve
temperature.
Toddlers Begin exploring environment, first by crawling, then
walking
Do not want to be apart from caregiver (separation anxiety)
May need special object to feel safe (toy, blanket).

Can speak simply; may understand more than they can
communicate
Frighten easily; believe they were “bad” and caused
situation
As they age, less likely to undress

Have caregiver nearby or next to patient during
assessment.
Perform PAT from a distance; address both child and
caregiver.
Use simple words and phrases but not “baby talk.

”Assure toddlers that they did nothing wrong; they were not
“bad.
”Perform physical exam by starting at the feet, to establish
trust with toddler.
Undress body areas for evaluation but cover up as soon as
possible.

Preschoolers Do not like being separated from caregiver
Rapid development of speaking ability
Fantastical thinking — pain and injuries may appear overly
dramatic to them
Do not like being undressed
May perceive illness/injury as punishment
Have caregiver nearby or next to patient.
Conduct PAT from a distance. Speak to both child and
caregiver.
Expose areas of the body only when necessary.
Use simple words and phrases to question and explain.
Reassure preschoolers that the situation is not their fault.
Engage more with the patient — ask about what happened.
School-age children Greater sense of autonomy
Can have sustained, sensible discussions
Concrete thinking
Increasing peer and popularity pressure
Modesty is important
Speak to both child and caregiver.
Ask patient about medical history and about the events surrounding
the current injury or illness.
Have school-age children help to make simple decisions.
Maintain modesty.
Explain as you examine and treat.
Adolescents Like to be treated as adults
Strong awareness of body image
Experiment and take risks
Create private space for questions and examination.
Maintain modesty. May need to separate adolescent from
caregiver.
Have adolescent involved in making more significant
decisions.
Adolescents may regress when confronted with significant stress. Be
prepared to support them as needed.