Download Nelson Essentials of Pediatrics , Seventh Edition by Karen J. Marcdante, MD Robert M. Kliegman, MD PDF

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By Karen J. Marcdante, MD Robert M. Kliegman, MD

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Interdisciplinary Team Intervention In many cases, a team of professionals is required to provide the breadth and quality of services needed to appropriately serve the child who has SHCN. The primary care physician should monitor the progress of the child and continually reassess that the requisite therapy is being accomplished. , nurse/therapist), providing direct stimulation for the child and training the family to provide the stimulation. As the child matures, a center-based nursery program may be indicated.

The size of induration, not the color of any mark, denotes a positive test. , home, school, barn) that has cracked or peeling paint? Is there a brother, sister, housemate, playmate, or community member being followed or treated (or even rumored to be) for lead poisoning? , lead smelting and automotive radiator repair)? Does the child live near an active lead smelter, battery recycling plant, or other industry likely to release lead? Does the family use home remedies or pottery from another country?

Apart from management strategies directed specifically at the problem behavior, regular times for positive parent-child interaction should be instituted. Frequent, brief, affectionate physical contact over the day provides opportunities for positive reinforcement of desirable child behaviors and for building a sense of competence in the child and the parent. Most parents feel guilty when their children have a developmental/behavioral problem. Guilt may be caused by the fear that the problem was caused by inadequate parenting or by previous angry responses to the child’s behavior.

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