Nutritional Disorders Telehealth Network Project

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Education on Developmentally Appropriate Expectations

Background Education for Providers
Caregivers often hold expectations for children that are developmentally inappropriate (e.g., they expect children to be able to make healthy eating choices when other members of the family are not, they expect children to be able to anticipate how current food choices will affect future health status). A major task for the health care professional is to assess and correct any developmentally inappropriate expectations. All children should be involved in making behavior changes, but they cannot be expected to implement changes independently.
Developmentally appropriate expectations for children and adolescents vary somewhat depending upon the given child. For youth with cognitive delays, their developmental age rather than their chronological age should be considered in formulating developmentally appropriate expectations. 
Understanding basic aspects of children’s thinking helps us to create developmentally appropriate expectations. In general, children and adolescents think about the world in different ways than adults do. The following are characteristics of the thinking of School Age Children: 
1) Present oriented (Focused on here and now)
2)Trouble anticipating consequences of behavior
3) Not able to think about future consequences
4) Can understand basic cause – effect relationships when these occur close in time
5) Concept of time still developing
6) Trouble with planning skills
7) Care a lot about fitting in, not being different (especially teens) 
Realistic expectations for school age children related to weight management include: 
1)Expecting child to help keep track of goals
2) having child learn about different food groups and identify examples of each
3) having child learn about different kinds of activities and decide which they want to try out
4) expecting child to understand the difference between everyday foods and sometimes foods. 
Unrealistic expectations for school age children related to weight management include:
1) creating and tracking goals on their own without parent reminders
2) taking medicine on own without parent reminders
3) making healthy choices on own without parent reminders or some type of concrete reward (e.g., points or stickers)
4) making healthy choices about eating or activity when parents ARE NOT making healthy choices
5) being responsible for doing physical activity on their own without parent reminders or some type of concrete reward
6) realizing that their eating choices now will impact their health in the future. 
Instructions for Provider
For families presenting in which developmentally inappropriate expectations are a concern, it is recommended that providers do the following:
1.      Talk with the family to understand specific ways in which parent expectations are not appropriate.
2.      Provide education using the points above to promote improved parent understanding of developmentally appropriate expectations.
3.      Develop a concrete plan for parent involvement so that the key tasks that parents are responsible for completing and that youth are responsible for completing are clearly articulated and developmentally appropriate. 

Supplemental Materials
© 2015 Medical College of Wisconsin
Page Updated 04/15/2014