Assessing Middle Childhood

Usually you will find little difficulty in examining children after they reach school age. While some may have unpleasant memories of previous clinical encounters, most children will respond well when the examiner is attuned to their level of development.

Many children at this age are modest. It is wise to provide gowns and to leave underwear in place until removal is required. It is also helpful to have children disrobe behind a curtain. Consider leaving the room when the children change with parents' help. Some children may prefer that siblings of the opposite sex depart, but most prefer to have a parent of either sex remain in the room, and parents of children under 11 years should remain with them. The order of the examination now begins to follow that used for adults. As at any age, examine painful areas last, and forewarn children about areas you are going to examine. If a child resists part of the examination, you can return to it at the end.

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