Thursday, 2 October 2014

One Minute Clinical Assessment: Five Words Can Make a Difference

Well-child checkups are being performed in every health clinic across America on a daily basis.  These clinics, aside from the fear of receiving shots, are perceived areas of safety for many kids.  Children undergo blood pressure checks, weight and height measurements, scoliosis, vision, and hearing screenings, and basic physical exams of the vital organs.  One of these vital organs is the heart.  While health professionals across the country lay the stethoscope on the hearts of these young patients, I encourage them to do more than just evaluate for murmurs.  Clinicians have the perfect opportunity to hear the hearts of children and these five words can make a difference:

                        Tell Me About Your School

A child’s emotional well-being can be evaluated and assessed in one minute if carried out correctly.  If phrased differently, “How’s school going?”  The answer is “FINE,” and a critical window of opportunity to connect on a personal level with a child that may be struggling has been missed.  For a child that is happy at school, a sense of confidence will spill forth in their answer, as they recount positive aspects of the school day.  For children that are unhappy at school, the opposite response will be encountered.  Negativity will be in the forefront of their thought processes, and it is the clinician’s job to evaluate the source of the negativity and make a difference.

There are many reasons that children may be unhappy at school that includes separation anxiety, struggling with academics, or uncomfortable social aspects involving peer groups and bullying.  Bullying has become a huge societal problem in school systems from elementary age through high school.  Again, the clinical setting is considered a safe-zone, and health care providers have the opportunity to evaluate if a child is being bullied or if they are the bully.  If a problem is sensed with the first statement, “Tell me about your school,” then narrow down the topic to the next five words that can make a difference.

                        Tell Me About Your Friends

A silent delay is a tell-tale sign of a problem.  Follow this up with a more direct approach.  Do you have mean friends?  Do you feel like you are mean to people sometimes?  I would encourage family practice and pediatrician offices to add the topic of bullying into their preventive medicine protocols.  After all, a well-child check-up should include the child’s emotional well-being, and this is certainly worth a minute of time. 
“An ounce of prevention is worth a pound of cure.”  Benjamin Franklin

Bli Marston Dugi, MPA-C

Co-Author, The Principle Gang