Child Development and Communicating with Children

• Attachment theory (Bowlby)
• Separation leads to distress
o Protest, despair, detachment (in the past, this was mistaken for recovery, so restricted parental access to hospitalised child to reduce the visible distress
o But, negative psychological outcomes (less play, less sleep, depression, anxiety, aggression, detachment)
• Good practice now
o Parent/carer access, attachment objects (e.g. teddy), home-like environment, play, continuity in staff, trained staff (specialist paediatric nurses), reassure not punished/abandoned
o Social referencing – reassure parents
• Childhood Cognitive Development (Piaget)
o Sensori-motor ? 0-2yrs
o Pre-operational ? 2-7yrs
o Concrete operational ? 7-12yrs
o Formal operational ? 12yrs+
• Implications
o Assess level of understanding, tailor communication
o Danger of metaphors with younger children
o Difficulty of expressing feelings
o Difficulty thinking about the future (abstract concept) even in adolescence: implications for adherence