Health Nutrition and Safety week2.pptx

Objectives
• Identify the basic concepts in child health nutrition and
safety.
• ·Develop a clear understanding on what is a well-being.
• ·Differentiate well-being from ill-being.
• ·Develop skills in identifying healthy and unhealthy child.
• ·Identify factors that contributes to healthy and unhealthy
way of living.
• ·Assess children in terms of their physical and mental
health conditions.

Introduction
to Child
Health
Nutrition and
Safety
"

Health, safety, and nutrition are closely intertwined
and dependent on one another. The status of each has a
direct effect on the quality of the others. For example,
children who receive all essential nutrients from a
healthful diet is more likely to reach their growth
potential, benefit from early learning opportunities,
experience fewer illnesses, and have ample energy for
play.

In contrast, a child whose diet lacks critical nutrients
such as iron may develop anemia, which can lead to
fatigue, diminished alertness, growth failure, and loss of
appetite. Disinterest in eating is likely to further
compromise the child’s iron intake. In other words,
nutritional status has a direct effect on children’s health
and safety, which, in turn, influences the dietary
requirements needed to restore and maintain well-being.

A nutritious diet also plays an important role in injury
prevention. The child or adult who arrives at school having
eaten little or no breakfast may experience low blood sugar,
which can result in fatigue, decreased alertness, and slowed
reaction times and, thus, increase an individual’s risk of
accidental injury. Similarly, overweight children and adults are
more likely to sustain injuries because excess weight may
restrict physical activity, slow reaction times, and increase
fatigue with exertion.

What Is Health?
– a state of wellness. Complete
physical, mental, social, and
emotional well-being; the quality of
one element affects the state of the
others.

Factors
Influence
Children’s Health
"

Characteristics transmitted from biological
parents to their children at the time of conception
determine all the genetic traits of a new, unique
individual.
Heredity sets the limits for growth, development,
and health potential. It explains, in part, why
children in one family are short while those from
another family are tall or why some individuals
have allergies or require glasses while others do
not.
Hereditary
"

Understanding how heredity influences
health can also be useful for predicting an
inherited tendency, or predisposition, to
certain health problems, such as heart disease,
deafness, cancer, diabetes, allergies, or mental
health disorders. However, it should be noted
that a family history of heart disease or
diabetes, for example, does not necessarily
predict the development of these conditions.
Hereditary
"

Many lifestyle factors, including physical
activity, diet, sleep, and stress levels, interact with
genetic material (genes) to determine whether a
child will ultimately develop heart disease or any
number of other chronic health conditions.
Hereditary
"

Although heredity provides the basic building
materials that predetermine the limits of one’s
health, environment plays an equally important
role. Environment encompasses a combination of
physical, psychological, social, economic, and
cultural factors that collectively influence the
way individuals perceive and respond to their
surroundings. In turn, these responses shape a
person’s behaviors and potential outcomes.
Environment
"

For example, two cyclists set off on a ride:
One wears a helmet, the other does not. The
choices each has made could potentially have
quite different outcomes if they were to be
involved in a collision. In turn, if the cyclist
who decided not to wear a helmet sustained
injuries, he or she is likely to experience
significant health, economic, social, and
psychological consequences.
Environment
"

 following a nutritious diet
 participating in daily physical and recreational activities
 getting adequate rest
 having access to medical and dental care
reducing stress
healthy life.
residing in homes, childcare facilities, schools, and workplaces
that are clean and safe
 having opportunities to form stable and respectful
relationships
Examples Of Environmental Factors That
Promote Healthy Outcomes Include:
"

There are also many environmental factors
that have a negative effect on health. For
example, exposure to chemicals and pollution,
abuse, illness, obesity, prenatal alcohol,
sedentary lifestyles, poverty, stress, food
insecurity, violence, or unhealthy dietary
choices can interfere with children’s optimal
growth and development.
Environment
"

refers to the behaviors and practices that protect
children and adults from unnecessary harm. Young
children are at especially high risk for sustaining
serious injuries because their developmental skills are
not well developed. As a result, unintentional injuries
are the leading cause of death among children from
birth to 14 years in the United States and Canada and,
sadly, many of these instances are avoidable (Forum
on Child & Family Statistics, 2009; Safe Kids Canada,
2009). Every adult who works with, or cares for, young
children, has a significant responsibility to maintain
the highest standards of supervision and
environmental safety (Mytton et al., 2009).
SAFETY

 knowing that an infant enjoys hand-to-mouth activities
should alert teachers to continuously monitor the
environment for small objects or poisonous substances
that could be ingested.
 Understanding that toddlers are spontaneous and
exceedingly curious should cause adults to take extra
precautions to prevent children from wandering away
or straying into unsupervised sources of water.
 Children who have developmental disabilities or
sensory disorders are also at increased risk of
sustaining unintentional injury and must be monitored
continuously (Lee et al., 2008).
Factors Affecting Children’s Safety

Nutrition
– The term nutrition refers to the science of food, its
chemical components (nutrients), and their
relationship to health and disease. It includes all the
processes, from the ingestion and digestion of food to
the absorption, transportation, and utilization of
nutrients, and finally the excretion of unused end
products. Nutrients are essential for life and have a
direct effect on a child’s nutritional status, behavior,
health, and development.

Nutrition
They play critical roles in a variety of vital
body functions, including:
_ supplying energy
_ promoting growth and development
_ improving resistance to illness and
infection
_ building and repair of body tissue

Children’s Nutrition and Its Effect on
Behavior, Learning, and Illness
Children’s nutritional status has a significant
effect on behavior and cognitive development.
Well-nourished children are typically more
alert, attentive, physically active, and better
able to benefit from learning experiences
(Rose-Jacobs et al., 2008).

Poorly nourished children may be quiet and
withdrawn, or hyperactive and disruptive during
class activities (Benton, 2009; Melchior et al.,
2009). They are also more prone to accidental
injury because their levels of alertness and
reaction times may be considerably slower.

Children who are overweight also face a
range of social, emotional, and physical
challenges, including difficulty participating in
physical activities, ridicule, emotional stress,
and peer exclusion (Wang et al., 2009).

Katona & Katona-Apte, 2008). Well-nourished children are
generally more resistant to illness and able to recover quickly when
they are sick. Children who consume an unhealthy diet are more
susceptible to infections and illness and often take longer to
recuperate. Frequent illness can interfere with children’s appetites
which, in turn, may limit their intake of nutrients important for the
recovery process. Thus, poor nutrition can create a cycle of
increased susceptibility to illness and infection, nutritional
deficiency, and prolonged recovery.

PROMOTING
CHILDREN’S
HEALTH
WELL-BEING

WELL-BEING
is the experience of
health, happiness, and prosperity.
It includes having good mental
health, high life satisfaction, a
sense of meaning or purpose, and
the ability to manage stress. More
generally, well-being is just
feeling well.
g

ILL-BEING
a condition of being
deficient in health,
happiness, or prosperity.

Wellbeing depends more than
ill-being on the personality traits
of extraversion and optimism,
and on the existence of
supportive social networks. Ill-
being is more strongly related to
SES, poor health, and low scoring
on the trait “personal
competence”

5 Major Types of Well-Being
 Emotional Well-Being.
The ability to practice stress-
management and relaxation
techniques, be resilient,
boost self-love, and generate
the emotions that lead to good
feelings.

Physical Well-Being.
The ability to improve the
functioning of your body
through healthy living and
good exercise habits.

Social Well-Being.
The ability to communicate,
develop meaningful
relationships with others, and
maintain a support network
that helps you
overcome loneliness.

Workplace Well-Being.
The ability to pursue your
interests, values, and life
purpose to gain meaning,
happiness, and enrichment
professionally.

Societal Well-Being.
The ability to actively
participate in a thriving
community, culture, and
environment.

The Healthy and Unhealthy Child

5 SIGNS TO
DETERMINE YOU
HAVE HEALTHY
KIDS
"

1. Physical Condition of Healthy Kids
You can look at their weight. Make sure that your kids
have a normal weight based on their age and height. Your
kids develop healthy growth if their weight is on a
desirable ratio. It shows that they take an adequate
amount of nutrients in their body.
You must be aware whenever they are either under or
over in weight since it might be problems with their body.
Meeting the pediatrician is important to know what the
trigger is and how to treat the condition properly.

2. Actively Move
Sometimes, you might be thinking that active children
are bothering. But you need to know that it is a sign that
your little ones are in healthy condition. Be thankful if
your kids actively move or play, minimally for a quarter
of an hour which may happen many times a day.
Actively move and exercise will reduce the fluids in
their bodies, but this condition will insist them to drink
enough amount of water. This is important to keep them
stay hydrated.

3. Healthy Kids have Great Appetite
You also can see the sign of healthy kids from their
appetite. They don’t refuse to consume different types
of foods. What’s make it more challenging is kids are
likely distracted by bright and vivid things as well as
animated shapes in their surroundings.
Since your little ones might be unpredictable in the
number of foods they eat, many parents make it more
creative to make them interested. For instance, making
meals using funny shapes kids like.

4. Clean and Strong Teeth
Open your kids’ mouths and look at their inside.
Kids whose growth develops healthily will have solid
and clean teeth.
The solid teeth show that your children enough
amount of nutrients such as calcium which play an
important role in the development of their bones and
teeth.

5. Regular Bowel Movement
Another healthy growth is shown from kids’
digestive systems. If they produce bowel movements
frequently, it means that children consume enough
amount of fiber from their daily intake. Not just that,
regular bowel movements also indicate that children
have a healthy immune system for their body
protection.

By knowing the kids’ progress as well as
maintain the healthy growth of your kids,
you can be more aware and control
parents. As you know the signs of healthy
kids, you will have the appropriate
knowledge to any regularity happens on
kids' growth and development and how to
cope with them.

SIGNS AND
SYMPTOMS OF AN
UNHEALTHY CHILD
"

 being underweight, overweight or obese
 constipation or changes in bowel habits
 being pale or lethargic
 tooth decay
 poor physical growth.
 In some children, poor diet may be associated with:
 behavioral problems
 sleep issues
 problems with emotional and psychological development
 poor concentration or difficulties at school
SIGNS AND SYMPTOMS OF AN UNHEALTHY CHILD

FACTORS THAT
CONTRIBUTE TO
HEALTHY AND
UNHEALTHY WAY OF
LIVING.
"

 Socioeconomic status,
 level of education,
 family,
 kin and social networks,
 gender,
 age and
 interpersonal influences
FACTORS THAT CONTRIBUTE TO HEALTHY AND UNHEALTHY WAY OF LIVING.

PROMOTING
CHILDREN’S
HEALTH
• HEALTH
OBSERVATIONS
AND
ASSESSMENT

Assessing children and adolescents is
challenging. Generally, the child/adolescent
in question would not have initiated the
consultation or may not agree with the need
for a consultation. The consultation may or
may not even be sought for the most
impairing problem at hand. While children
may be able to report the nature of
symptoms, they may not be very good at
reporting the timing and duration of their
problems.

They may not report problems if they are
embarrassing or show them in a bad light. Clinical
assessments with children and adolescents are,
therefore, elaborate and require the clinician to be
astute and conscientious in obtaining information
from multiple sources and settings, i.e., the child,
parents, teachers, and other caregivers. There are
bound to be discrepancies in the report; nevertheless,
multi-source information is a requirement during
diagnosis and management.
Assessment and treatment are generally
multidisciplinary. Information may also be gathered in
a staged manner to not overwhelm the child and
family. Gathered information must be shared across
professionals involved in the care of the child and
family.

OBJECTIVES OF
CLINICAL
ASSESSMENT
"

The central goal of a clinical assessment is to
come to a case formulation that would guide
management decisions.
Delineating signs and symptoms through
detailed clinical history and examination help
ascertain key areas of concern and presence
(or absence) of a mental health disorder.
OBJECTIVES OF CLINICAL ASSESSMENT

To adequately comprehend the origins,
maintenance, and factors affecting remission
from the disorder, it is essential to place the
child within a psychosocial background, relate
the presentation to his/her unique context,
and to gather details about what has
happened to the illness so far, including what
has been the treatment and response history.

A clinical assessment also aids the child
and family in developing a clearer
understanding of their own difficulties
and gives them an opportunity to reflect
on the information they share.

Establishing Therapeutic Alliance with The Child/Family
Health professionals working with children know
that interacting with children is no child's play! As
adults we often find ourselves at a loss of ideas
when interacting with children; as health
professionals we also tend to get preoccupied with
“saying the right thing,” and worrying about
whether the child will “abide” by given advice.
Clinical Assessment.

Clinicians sometimes neglect establishing a
rapport in their work with children and
practice purely paternalistic medicine. There is
a need to respect the child's autonomy as well
as look out for their best interests. Shared
decision-making, with selective paternalism
where needed, is the best form of practice,
especially with children and families.

Background And Context of Presentation
Often, the first health-care contact for children and
adolescents with behavioral concerns is not a mental
health professional. Pediatricians or neurologists may be
consulted first. Sometimes, difficulties that the child is
experiencing behaviorally, emotionally or with respect to
academics may be noticed by schoolteachers. The
referral context and process shed light on the nature of
problems, functional impact, and knowledge, attitude,
and practices of the family. This has implications on
future of management.

Clinical History And Examination
It is ideal if the parents can narrate the
concerns they have had about the child from
the “start” in a chronological manner, covering
details about when they sought what
consultation and how it impacted the child,
both gains and any adverse reactions. This
ideal scenario does not exist in child and
adolescent psychiatry.

Unlike in adults, the premorbid self is an
evolving entity in children and adolescents,
and environmental contexts impact a child's
behavior significantly. Parents are, therefore,
at a loss for how to describe the onset, and
course of concerns. Initially, the parents must
be allowed to talk about the concerns in
whichever manner they want to, starting at
whatever point in the child's life they want to.

The goals of clinical history and examination are
to evaluate and ascertain the following:
Developmental trajectories and attainments
Presenting behavioral and emotional problems
Current functioning in various settings
Strengths/assets of the child/adolescent and the
family
The highest level of functioning before the onset
of the current concerns.

 Past Evaluation And Interventions
Details about past assessments, evaluations,
treatments, response to the treatment, and
side effects must be collected. This informs
future direction of evaluation and
management.

Use Of Developmentally Appropriate
Techniques
Expressive channels evolve from play in very young children,
to art and other creative methods, and finally to verbal dialogue
in adolescents. The manner of exploration and engagement with
children must follow this understanding. Therefore, waiting for
preschool children to cooperate across an interview table may not
be successful, whereas letting the child sift through toys, or be in
a play area may reveal his activity levels, attention span, ability
to tolerate frustration, and cognitive abilities. Use of colors, pens,
paper, puzzles, peg boards, can all be used in the office to
facilitate interaction with young children.

Parent-Child Interaction
In toddlerhood, with their increasing motor and
cognitive capacities, children are quite exploratory. It
is during this time that attachment and parent-child
responsivities can play a significant role in
facilitating/hampering growth. Some simple
observations during consultation are listed in Children
with developmental problems may not show these
behaviors and may stay engrossed in solitary
activities.

Multidisciplinary Referrals
Child and adolescent psychiatry necessitate
evaluations and interventions from a multidisciplinary
team most often consisting of a clinical psychologist,
pediatrician, psychiatric social worker, speech and
language pathologist, occupational therapist, and
other health-care professionals. The psychiatrist
needs to make appropriate referrals to these
professionals to gain a holistic understanding of the
child and family and plan interventions accordingly.

Record Keeping
Children, parents, and families who come in for a
psychiatric consultation are often loaded with
historical details and are distressed by the referral and
evaluation process. It is understandably tedious for
them to have to repeat information over consultations.
Reviewing clinical notes from previous consultations
puts the clinician in a clearer frame of mind in terms of
future course of enquiry and future planning. It is good
practice to have a recording format for recording
history, examination, and clinical discussion details.

Record Keeping
The information gathered can be fed back to
the family so that they have an understanding
about the future course of action - one child may
need to be scheduled for an IQ test, another
child may need to come in for a more elaborate
consultation with additional members of the
family, and so on.

The physical examination must be guided by
presenting complaints, hypotheses, and
differential diagnosis that the clinician is
considering based on history obtained from the
child and family Generally, the physical
examination begins with recording vital signs,
and height and weight on a growth chart. Head
circumference must also be recorded on a
growth chart.

This helps track vital parameters over time as
they are important measures of well-being and
optimal development in children and adolescents. It is
crucial to measure the height, and weight in children
who are on stimulants or selective serotonin
reuptake inhibitors (SSRIs) at every follow-up.
Calculating the child's Body Mass Index (BMI) and
measuring waist circumference has also become
important given the extensive use of atypical
antipsychotic drugs.

In child and adolescent psychiatry, apart from the
presence of systemic illnesses and neurocutaneous
disorders, the clinician must also look for signs of
intentional self-injury, abuse (scars, bruising, and
petechiae), abrasions, skin picking that may be
suggestive of compulsive behaviors; patterns of hair
loss either on the scalp or other parts of the body
may be suggestive of trichotillomania. Examination
of the head, eyes, nose, and throat
• Examination of skin, hair, nails

This is of utmost importance in psychiatry
and must include an examination of the cranial
nerves, sensory and motor systems, balance,
coordination, and reflexes. Mental status
examinations must pay particular attention to
changes in the emotional state and cognitive
functions.
Neurological examination

A psychiatrist under most circumstances is not
required to perform a genital examination. In certain
genetic disorders such as Prader Willi Syndrome,
Klinefelter's Syndrome, or other such conditions where an
inspection of the genitalia is required for making a
diagnosis, it can be done, with prior permission from the
parent/guardian, in the presence of another health-care
provider and taking adequate care to keep the young
person comfortable. Otherwise, referral to a pediatrician
for evaluation may be considered.
Genital examination

Laboratory investigations must be guided by
history and physical examination There is no
standard battery of investigations for
psychiatric disorders. Under ideal
circumstances, a child will have a pediatrician
involved in their regular care. All investigations
must be done in the context of the child's global
health care.
Laboratory investigations

A history of similar or other behavioral
concerns and history of medical issues must be
asked for. It may not be easy to disentangle
“past episodes” in a child's clinical history as
developmental, emotional, behavioral issues
most often run a continuous course. In
developmental disorders, therefore, there is no
history.
Past history

Several associations are seen between pregnancy,
maternal health, early exposure related variables and
developmental and behavioral outcomes during childhood
and adulthood. At the clinical assessment level, it may not
be possible to always conclude causal influences, however,
the knowledge of these variables can guide further
evaluations, shed light on psychosocial circumstances of
the family, help the parents, and clinician gain some
perspective on the “global risk” in a child.
 Pregnancy, pre-natal, early developmental history

The developmental history of a child, across
different domains gives the “background” on which to
understand the current behavioral concerns and to
plan pharmacological and psychotherapeutic
management. For instance, a child with a
developmental history of social and language delay,
presenting with peer relationship issues and bullying
in school, most probably has social skill deficits
arising from autism spectrum disorder.
Developmental history

In addition to developmental milestones, the
temperamental characteristics of a child must
be elicited. Temperament refers to patterns of
emotional and behavioral reactivity to
environmental situations and capacity for self-
regulation.
Temperamental history

School is the primary occupational arena for
children and adolescents. It is where elaboration of
developmental abilities, especially cognitive and
socio-emotional abilities, occurs. Information about
school should be collected from the child, parents,
and teachers at school. There is a large amount of
information that could be collected about the
schooling experience of a child.
Schooling history

The child and the parents must be asked about the
skills, and interests of the child. It is important to frame
specific questions to get an accurate understanding about
the child. Enquiring about the child's interests, skills, and
talents, can be an icebreaker or a communication starter
with the child. It makes the child aware that the
interviewer sees the child as a “person” and not just a
problem. The clinician must make a conscious effort to
separate the illness from the personhood of the child.
Child's interests, skills, and talents

Family history is a vital component in the
detailed assessment of a child/adolescent. The
occurrence, manifestation, and exacerbations
of all kinds of mental health issues are affected
by the medical/psychiatric history in the family
and relational dynamics.
Family history

C h i l d P r o f i l i n g
Activity
1 . N a m e :
2 . A g e :
3 . H e i g h t :
4 . W e i g h t :
5 . G r a d e L e v e l :
6 . R e s u l t o f N e w b o r n S c r e e n i n g :
7 . M e d i c a l C o n d i t i o n :
8 . F a m i l y ’ s M e d i c a l H i s t o r y :
9 . C h i l d ' s M e d i c a l H i s t o r y :

A n s w e r t h e f o l l o w i n g :
Activity
1. Explain how genetics and environment influence the
quality of a child’s well-being.
2. Describe how teachers can use their knowledge of
children’s development for health promotion.
3. Discuss why it is important to involve and include
families in children’s health education activities.
What steps can a teacher take to be sure that
children’s cultural beliefs are respected?

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