A nurse is assessing a 4-year-old child during a routine health visit. Which developmental milestone would be most appropriate to assess for this age group?
1Ability to hop on one foot and draw a person with at least 3 body parts
2Ability to hop on one foot and draw a person with at least 4 body parts✓ 정답
3Ability to hop on one foot and draw a person with at least 5 body parts
4Ability to hop on one foot and draw a person with at least 2 body parts
해설
At age 4, expected milestones include hopping on one foot and drawing a person with at least 4 body parts, reflecting gross motor and fine motor/cognitive development.
Clinical Judgment
This question assesses the ability to accurately recognize and apply age-appropriate milestones, which are central to developmental assessment. A 4-year-old child is in the preschool age group, and the representative developmental achievements for this period are hopping on one foot and drawing a person (including at least 3-4 body parts). These are key items also confirmed in standardized developmental screening tests like the Denver II or ASQ. The other options correspond to milestones for younger (tying shoelaces) or older (riding a bicycle without training wheels, reading sentences) children, so the nurse must plan the assessment based on expectations appropriate for the child's exact age.
Memory Tip:
Remember it as Preschool Hoppers Draw People (PHDP). The key is that preschool-aged children around 4 years old Hop on one foot and Draw people.
KR vs US:
While the developmental milestones themselves are universal, there can be differences in assessment tools and cultural context. In Korea, activities like 'jumping over' and 'cutting with scissors' are also commonly evaluated, whereas in the US, the Denver Developmental Screening Test (Denver II) or Ages & Stages Questionnaires (ASQ) are more standardly used. Additionally, in the US NGN, there is a strong emphasis on early detection of developmental delays and notifying the HCP! to connect the child with Early Intervention services.
임상 시나리오
Clinical Practice Guide
When assessing the development of a 4-year-old child, play-based observation is the most effective method. Prompt gross motor skills by saying, "Can you hop on one foot like a bunny?" and assess fine motor skills and cognitive development by giving them crayons and paper and asking, "Can you draw someone in your family?" Parent reports are also very important. Check the behaviors they show at home or in preschool.
Caution
In SATA (Select All That Apply) questions that ask, "Which are appropriate developmental milestones for a 4-year-old child?", options like "hopping on one foot," "drawing a person (3-4 parts)," "following 3-step instructions," and "speaking in sentences of 10 or more words" can all be correct together. For single-answer questions, you should choose the option that combines the two most typical and specific skills. Keep in mind that "tying shoelaces" is usually a milestone for ages 5-6 (school age).
핵심 개념
Developmental Milestone — Developmental milestones. Functional skills or behaviors that a child is expected to achieve by a specific age range, serving as indicators of neurological, muscular, and cognitive development.
Preschool Age — Preschool period. Generally, this is the period from 3 to 5 years of age, falling between infancy and school age, and is a time of rapid development in language, social skills, and gross/fine motor skills.
Gross Motor Skills — Gross motor skills. These involve movements using large muscle groups such as the trunk, arms, and legs, with examples including walking, running, climbing, and standing on one foot.
Fine Motor Skills — Fine motor skills. These involve precise movements of small muscle groups, such as the fingers and hands, with examples including drawing, writing, using scissors, and stacking blocks.
Denver Developmental Screening Test (Denver II) — Denver Developmental Screening Test. A widely used standardized tool to screen for developmental delays in children from birth to 6 years of age across four domains: personal-social, fine motor-adaptive, language, and gross motor.