RISK FOR DELAYED DEVELOPMENT
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
• Lead poisoning
• Chronic illness
• Substance abuse
• Congenital disorders
• Vision impairment
• Failure to thrive
• Foster child
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
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
• Identify risk factors that may interfere with child’s development.
SUGGESTED NOC OUTCOMES
Family Functioning; Growth; Parenting Performance; Personal
Health Status; Risk Control
INTERVENTION AND RATIONALES
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
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.
SUGGESTED NIC INTERVENTIONS
Nutrition Management; Family Process Maintenance; Coping
Enhancement; Family Integrity Promotion; Maintenance; Normaliza-
tion Promotion; Substance Use Prevention; Substance Use Treatment;
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.