TABLE 11-1
Types of Health Assessment Records
Type of Record Definition
Best Used For
Limitations
Anecdotal
Brief narrative accounts
that describe health
conditions and behavior
Daily open-ended
observation
Relies on memory of
observer, can be out of
context
Running Record
Detailed narrative
account in sequence of
health status conditions
and behaviors
More comprehensive
and keeps better track
over time
Time consuming; teacher
must have time apart
from children to record
Checklist
Lists of specific health
status, communicable
diseases, absence of
signs, symptoms; monthly,
quarterly, and yearly
growth and development
observations
Daily scan
Specific traits and
behaviors; does not
describe
Time Sampling
Records frequency of
health status condition or
behavior occurrences
Good for over time, takes
less time; objective and
controlled
Does not describe
condition or behavior
Event Sampling
Waits for health condition
or behavior to occur, then
records specific behaviors
Recurring problem;
objective and defined
ahead of time
Misses details of
condition or behavior
Adapted from: Observing the Development of Young Children, by Janice J. Beaty, 2002, New York, NY: Macmillan, and Week by Week
Documenting the Development of Young Children, by Barbara A. Nilsen, 2005, Clifton Park, NY: Thomson Delmar Learning.
TABLE 11-2
Daily Health Checklist
CHECK FOR:
Activity level
Severe sneezing or coughing
Discharge from nose, eyes, or ears
Breathing difficulties
Sores
Swelling or bruises
Rashes or unusual spots
General mood and behavior
Skin color (pale or flushed)
TABLE 11-3
Developmental Norms for
Gross Motor Skills in Infants
Motor Skill
Months at Which 90 Percent of
Infants Master Skill
Lifts head up while lying on stomach
3.2
Sits with head steady
4.2
Rolls over
4.7
Sits alone
7.8
Stands holding on
10
Walks holding on
12.7
Stands alone steadily
13.9
Walks well
14.3
Walks up stairs with help
22.0
Kicks ball forward
24.0
Reprinted with permission of DDM. © 1969, 1989, 1990 W. K. Frankenburg and J. B. Dodds © 1978
W. K. Frankenburg.
TABLE 11-4
Developmental Norms for
Motor Skills of Children
Ages 2½ to 3½
Gross Motor Skills
Fine Motor Skills
Walks well with a normal gait
Uses eating utensils well
Runs in a straight line
Copies a circle
Jumps in the air with both feet
Scribbles
Throws a ball
Stacks blocks
Reaches for objects with one hand
Manipulates large puzzle pieces
Climbs
Smears paint
Hangs by both hands
TABLE 11-5
Caution Signs for
Motor Development
CHECK FOR:
WARNINGS
Has difficulty judging distances in relation to himself
Lacks large muscle control and appears clumsy and uncoordinated
Has difficulty pointing out or locating parts of the body
Lacks small muscle control in things like cutting and coloring
Lacks steady hand or arm when reaching or stacking; arm or hand
appears to tremble
Has difficulty walking or walks exclusively on the toes
After walking has been mastered, falls frequently or has difficulty using
stairs
At the age of 3 years has difficulty building a tower of more than four
blocks or cannot copy a circle
TABLE 11-6
Caution Signs for Vision
Problems
CHECK FOR:
WARNINGS
Eye Problems:
Visual Perception
Difficulties:
Persistent redness, swelling, crusting,
or discharge in eyes or eyelids
Short attention span
Excessive tearing
Unable to visually sequence
Frequent squinting
Difficulty with color vision
Eyes that look crooked or crossed or
that do not move together
Inability to follow objects
with both eyes, near and
far ranges
Head held in a tilted position
Drooping eyelids
Continuous rubbing
Shutting or covering one eye
Tilting head forward
Eyes that wander
Inability to see objects unless
they are close
Crossed or misaligned eyes
Lack of balance
Visually distractible
TABLE 11-7
Developmental Hearing Norms
CHECK FOR:
Birth–3 months
Does the child listen to speech?
Does the child cry or startle at noises?
3–6 months
Does the child smile when spoken to?
Does the child try to turn toward speaker?
Does the child seem to recognize mother’s voice?
6–9 months
Does the child respond to his name?
Does the child turn head toward where the sound is coming from?
Does the child notice and look around for source of new sounds?
9 months–1 year
Does the child listen to people talking?
Does the child look up when you call?
Does the child look around when hearing new sounds?
1–2 years
Can the child follow two requests such as “go to the kitchen and get your cup?”
2–4 years
Can the child point to pictures in a book upon hearing the object named?
Does the child understand conversation easily?
Does the child hear the television or music at the same loudness level as
everyone else in the room?
Does the child notice normal sounds like the phone, the doorbell, or a dog’s bark?
Does the child hear you when you call from another room?
Adapted from Developmental Norms for Speech and Language by the American Speech-Language-Hearing Association © 2005.
TABLE 11-8
Normal Speech and Language Developmental Patterns
CHECK FOR:
Age
Expressive Language
Ability to Understand
3–6 months
Babbling, vocalizing pleasure
Smiles in response to speech; seeks
sound source; recognizes familiar
people and objects
7–9 months
Consonants—b, d, m, t, p, z;
babbling; imitates speech sounds
Responds to gestures and “no”; can play
peek-a-boo, pat-a-cake, and bye-bye
10–12 months
First true word may appear;
intonations begin; uses all sounds
in vocal play
Relates object and name; can follow
simple body action commands; always
responds to own name
1–1½ years
Uses 3 to 20 single words; uses
gestures
Follows simple commands; recognizes
some body parts and names for objects
1½ to 2 years
Uses 20 to 60 words; combines two
words in sentences; 65 percent
speech intelligible
Understands 200 to 300 words; can
answer simple yes-or-no questions
2–3 years
Uses 200 to 500 words; uses
three- and four-word sentences;
grammar emerges; 70 to 80
percent of speech intelligible
Understands 800 to 900 words; can
answer what, why, where questions;
can listen to short stories
3–4 years
Uses 800 to 1,500 words; uses
four- and five-word sentences;
asks questions
Understands 1,200 to 1,500 words; can
compare (up and down); responds to
two-part commands
4–5 years
Uses 1,500 to 2,000 words; very
intelligible speech; uses eight-word
sentences; can tell long stories
Understands 2,500 words; answers
complex questions; has some color and
number concepts
TABLE 11-9
Caution Signs for Screening
and Referral for Speech and
Language Development
CHECK FOR:
WARNINGS
No intelligible speech by 2 years of age
Voice is monotone, too loud or soft, or of poor quality
Difficult to understand after age 3
Nasal quality to voice
Speech too fast or too slow
Difficulty in expressing self, organizing thoughts
Makes very few or no attempts to speak
Inability to produce all speech sounds interfering with communication
Difficulty following directions at appropriate developmental language level
Difficulty in engaging in verbal activities with other children
Stuttering
After age 4, inability to communicate in sentences with more than three
words or to use “me” or “you” appropriately
TABLE 11-10
At-Risk Indicators for
Children’s Vulnerability to
Poor Mental Health
CHECK FOR:
WARNINGS
Aggression or acting-out behaviors, without provocation
Passivity, lack of response, or total withdrawal
Disorganized behavior socially or in play
Poor or inappropriate attachment patterns
Low self-esteem
Easily overstimulated
Unresponsive to verbal cues or affectionate overtures
Clingy, dependent
Hypersensitive
Unable to make decisions or solve problems
Temper tantrums or very irritable
Mood swings with no explanation
Lack of attention or ability to focus
Easily frustrated
Overreaction or inappropriate response to everyday events
Inability to transition easily
Indifference to parent
Avoids eye contact
Anxiously follows teacher everywhere
Little or no interest in others
TABLE 11-11
24-Hour Dietary Recall
Name: Dane Leonard
G ⴝ Grains, bread, and cereals
V ⴝ Vegetables
M ⴝ Meat
Age: 3 years, 2 months
MM ⴝ Milk and milk products
F ⴝ Fruits
Breakfast
Snacks
½ cup sugared cereal (1 G)
1 apple (1 F)
1 cup milk (1 MM)
2 chocolate chip cookies
1 banana (1 F)
1 cup grape juice (1 F)
Lunch
1 cup milk (1 MM)
1 corn dog (1 M)
How many servings of each in one day?
chips
Grains, Breads, and Cereals
punch
(G)—1
1
Fruits (F)—3
Dinner
Vegetables (V)—2
1 chicken leg (1 M)
Milk and Milk Products (MM)—4
peas (1 V)
Meats (M)—2
/2 cup pudding (1 MM)
mashed potatoes (1 V)
1 cup milk (1 MM)
Assessment: Low on grains, breads, and cereals; high on milk and milk
products
TABLE 11-12
Food Frequency Questionnaire
for Children
Name _________________________________________
Age ______________
Indicate how many times on average your child eats the following foods in
a week by marking down the number of times in the category that most
describes your child’s eating pattern.
D ⴝ Daily
O ⴝ Often
S ⴝ Sometimes
R ⴝ Rarely
Frequency
Food
D
O
S
R
Milk and milk products: cheese, milk, yogurt,
ice cream, and pudding
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
■
Meat, meat products, and meat substitutes:
beef, chicken, pork, lamb, fish, egg, lunch
meat, bacon, dried beans, peas, and
peanut butter
Grains, breads, and cereals: rice, pasta,
tortillas, grits, breads, cereals
Fruits and vegetables
Other: fats, oils, sweet bakery goods,
fast foods, and candy
What type of milk does your child drink?
skim
1% lowfat
2% lowfat
whole
formula
breast
■
■
■
■
■
■
How many meals, including snacks, does the child eat in one day? _______
Also, explain the child’s eating habits: __________________________________
_______________________________________________________________________
_______________________________________________________________________
Are there any dietary restrictions or limitations practiced by your family?
No ■
If yes, please explain. Yes ■
_______________________________________________________________________
_______________________________________________________________________