At risk for delay of 25% or more in one or more of the areas of

social or self-regulatory behavior, or in cognitive, language, gross or

fine motor skills


• Adopted child

• Hearing impairment

• Behavior disorders

• Inadequate nutrition

• Brain damage

• Genetic disorders

• Chemotherapy

• Lead poisoning

• Chronic illness

• Substance abuse

• Congenital disorders

• Vision impairment

• Failure to thrive

• Poverty

• Foster child

• Violence

ASSESSMENT FOCUS    (Refer  to  comprehensive  assessment  parameters.)

• Coping

• Roles/relationship

• Communication

• Values/beliefs

• Emotional


The child will

• Continue to grow and gain weight in accordance with growth

chart of age and sex.

• Consume _____ calories and ________ ml of fluids representing

________ servings (specify for each food group).

• Participate in activities and be provided with a supervised, uncon-

fined environment that includes age-appropriate toys and fosters
interaction with child’s development.

The parents will

• Express understanding of measures to reduce child’s risk for

delayed development.

• Identify risk factors that may interfere with child’s development.


Family Functioning; Growth; Parenting Performance; Personal

Health Status; Risk Control


Determine: Assess family’s developmental stage; family roles; family

rules; socioeconomic status; family health history; history of substance

abuse; history of sexual abuse of spouse or children; problem-solving

and decision-making skills; religious affiliation; ethnicity. Assessment

information will aid in developing a workable plan of care.

Perform: Weigh and measure child. Review growth chart to establish

current height and weight values.

Establish a meal program to meet the child’s nutritional needs.

Create an environment in which family members can express

themselves openly and honestly. Establish rules for communication

during meetings with the family. Having rules allows everyone to

participate and keep the discussion on the designated topic.

Inform: Teach parents about nutritional requirements needed for

child of specific weight and age. Discuss various meal choices avail-

able to the child. Providing instruction in writing simplifies the par-

ents’ role in selecting healthy foods.

Educate parents about child’s need for quality interaction with

family members and others. Inform parents about age-appropriate

activities and toys as well as potential playmates for a child of spe-

cific age. Emphasize importance of providing an unconfined, super-

vised environment in which the child can play to encourage play

that encourages the child to move freely.

Educate parents about risk factors that may lead to delayed devel-

opment, such as lack of supportive interactions or age-appropriate

activities. The ability to recognize risk factors will promote getting

help for the parents and child sooner.

Teach coping skills to parents to enable them to deal effectively

with the child’s needs.

Attend: Encourage parents to listen to the child and communicate in

a loving, supportive way in order to allow the child to maintain a

positive attitude.

Encourage parents to identify preventive measures they may initi-

ate at home to ensure continuity of care. Consistency in providing

care will help the child understand that the plan carries over to all

aspects of his or her life.

Manage: Provide parents with a copy of child’s teaching plan. This

helps to reinforce what the child is learning.

Refer to case manager/social worker to ensure that a home assess-

ment is done.

Refer to nutritionist for follow-up with food issues.


Nutrition Management; Family Process Maintenance; Coping

Enhancement; Family Integrity Promotion; Maintenance; Normaliza-

tion Promotion; Substance Use Prevention; Substance Use Treatment;

Risk Identification


Moss, J. (2005, March). Development of a functional ability scale for children

and young people with myalgic encephalopathy (ME)/chronic fatigue syn-
drome (CFS). Journal of Child Health Care, 9(1), 20–30.