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. |