DELAYED GROWTH AND DEVELOPMENT
Deviations from age-group norms
• Altered physical growth
• Delay or difﬁculty in performing motor, social, or expressive skills
typical of age group
• Flat affect
• Listlessness and decreased response
• Inability to perform self-care activities or maintain self-control at
• Effect of physical disability
• Multiple caretakers
• Environmental deﬁciencies
• Prescribed dependence
• Inadequate caretaking
• Separation from signiﬁcant
• Inconsistent responsiveness
• Stimulation deﬁciencies
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Family roles and responsibilities
• Cardiac function
The child will
• Demonstrate skills appropriate for age.
• Participate in developmental stimulation program to increase skill
The parents will
• Express understanding of norms for growth and development.
• Use community resources to promote child’s development.
• Provide play activities to promote child’s development.
SUGGESTED NOC OUTCOMES
Child Development: Middle Childhood; Growth; Physical
Maturation: Female; Physical Maturation: Male
INTERVENTIONS AND RATIONALES
Determine: Monitor weight and height weekly. Monitor nutritional
intake, activity level, and sleep patterns. Documentation of these
factors will help measure progress over time.
Assess cardiac functioning and respiratory status to ensure that
child is healthy enough to participate in activities.
Assess child’s motor skills, communication patterns, social skills, and
cognitive abilities to evaluate where skill development may be needed.
Assess support systems available to child and parents. Where there
are gaps, other sources of support may need to be put in place.
Perform: Establish a meal program to promote nutritional needs.
Weigh and measure child weekly and review growth-chart curve to
Establish a routine sleep schedule for child to ensure that the
child is healthy enough to participate in an activity.
List age-appropriate activities and exercises to stimulate bone and
muscle development and promote cardiovascular health. Provide
appropriate play activities, such as building blocks, dolls, crayons,
or games to promote development.
Administer prescribed drugs and treatments as ordered. Ensure
parents and child understand intended action and possible side effects
to ensure therapy will continue as planned.
Provide an environment that is conducive to promote changes the
child must make. Environment can be a powerful motivator.
Inform: Provide parents with information about the causes of
delayed growth and development. Provide written information to
help them know what they can expect as a result of treatment.
Discuss age appropriate nutritional requirements with parents and
child and teach additional risk factors associated with delayed
growth (e.g., lack of regular sleep, environmental hazards). Teach
appropriate activities and encourage frequent play with child. These
measures promote continuity of care.
Attend: Five child positive reinforcement for demonstrating appropri-
ate skills and behavior and encourage parents to do the same to
encourage the child to continue developing skills.
Encourage child and parents to express feelings about present
state of child’s health. Listen attentively with understanding about
the self-esteem associated with what is considered by peers to be
other than normal. Parents need to be encouraged ﬁrst to accept the
child as he is and then encourage the child to develop new skills
Development can occur only when parents and staff are both realis-
tic about the child’s present stage of development.
Manage: Provide parents with referrals to appropriate community
resources, including sources for ﬁnancial assistance, child care, and
suppliers of adaptive equipment, to ensure the child’s right to receive
remedial and educational support in accordance with the disability,
as guaranteed by federal law.
SUGGESTED NIC INTERVENTIONS
Developmental Enhancement: Child; Health Screening; Nutrition
Management; Risk Identiﬁcation; Self-Responsibility Facilitation
Wagner, J., et al. (2006, September–October). Nurses’ utilization of parent
questionnaires for developmental screening. Pediatric Nursing, 32(5),