ISPP 2015

Career Opportunities in Pharmacy
What happens during a health assessment of a child who has gone into care?


Morning, my name is Gavin Cobb, I am one of the community paediatricians. I’m a children’s doctor. And what’s your name? Cora. Cora, that is a very pretty name and I love your sparkly tights Cora. I’ll tell you what, I am going to have a chat to your foster mum who has come with you. and we have some toys over here. Would you like to go and play with them? You go ahead and have a wee look to see what’s there. So, have you been to one of these health assessments before at all? No, I haven’t this is my first time. Is this your first time fostering as well? It is, yes. How long have you been looking after Cora for? Cora came to us three weeks ago. Okay, it has been very useful that you sent in the carers report. Thanks very much for that. Okay. How did she settle in with you? Has she settled in yet? I think she is probably still in the process of settling. When she came to us initially, she was quite detached, quite quiet a little bit anxious, I think. But over the three weeks, she is participating a little bit more in family things that are going on. She seems a bit more confident with us a bit more relaxed. And how is her sleep been then? Initially her sleep was a bit disturbed at night, she would wake up one or two times maybe, have a little bit of a cry, want somebody to be there with her. That seems to be getting less and less now. And do you have any concerns about any aspect of her physical health or behavior at all? Well, I think probably my biggest concern at the moment is around potty training. When Cora came to us three weeks ago she was in nappies all the time, I was told. Yes, I think it has been quite a lot of instability in her life and then sometimes you see children even who has been potty trained before actually take a bit of a step back and regress a bit with their training, so I think at this point it is understandable that she is maybe having some issues. Just try to be as patient as possible but it would be appropriate, yes if you feel she is ready to try toilet training. Okay, that’s great, that’s helpful, thank you. Okay, so what I think we will do now is we’ll get Cora’s birth mum Kylie to come in. Is that okay? That’s fine. That’s okay. Right. Cora, I am just going to get mummy to come in. Is that okay? Yeah. Thank you very much for coming today. I am Gavin Cobb, one of the community paediatricians. Hi. You have met before as well, haven’t you? Ok, and here is Cora coming to see you. So thank you very much for filling out the parental health questionnaire. I think you did that with the social worker support? Yes. Okay. So what we’ll do this morning is I am just going to ask you just a few questions about your pregnancy and about your health and family health and things like that. Because sometimes that can be very useful for letting us know what a child’s health is maybe going to be like or if she has health issues in the future sometimes they might be related to any family health issue as well. Okay. So Kylie, can you tell me how far on were you when you found out you were pregnant? It was like 5 months, when I found out I was pregnant. Okay, so that is quite late on, isn’t it? And before you found out you were pregnancy, did you drink alcohol at all? Yes, me and my friends went out a lot and got drunk. And after you found out you were pregnant. Did you have any time drinking alcohol then? Not a lot. Sometimes. Okay, that’s fine. It is very helpful you telling me that. Thank you very much for your honesty with that as well. Did you need to be in hospital at any point? Not when I was pregnant. Not until she was born, because she was born 4 weeks early. So she had to be in the special care unit, she was so tiny, she was so much lighter than all the other babies. Any sort of illnesses? Yeah, she had chicken pox, when she was 1. Any illnesses maybe run in your mum or dad’s side of the family? My brother had learning problems, so he had to go to a special school. My mum and my gran had breast cancer. And Kylie, is anything else about Cora whenever she was younger, that you are concerned about or with her health or development, at all? I don’t know, she just she couldn’t feed properly herself, I guess. Okay. And have you noticed anything about her availability to feed herself or hold spoons? She definitely was reluctant to start feeding herself when she came to us and she doesn’t grip her spoon as well as she might, really. I suppose if she is doing some drawings, she finds it difficult to hold onto a crayon and actually doing a picture. That is very helpful. Thank you very much for sharing that with us. I think , now is probably a good time for me to have a wee look at Cora. I’ll tell you what, I have a few things in here, that I would like to play with with you, if that is okay? From my blue briefcase. Oh, my goodness, look who is this? What is this? A dolly? Is that a dolly? Do you think she is friends with Who is this? Raffy I think she’d like to meet Raffy, wouldn’t she? She can sit down here. He is quite scared Is he quite scared? You don’t need to be scared of dolly. Can you show me? Where is dolly’s eyes? Yes! And where are your eyes? Can you point them? Yes, they are, aren’t they? Can you show me? Can you put these pegs into there? Well done. It is really easy. Is it really? Oh, let’s see how fast you can go then. Faster, faster, faster. Okay, well done, keep going, keep going. Whoopsie, it’s stuck to your thumb. Do you know what these are? What sort of animal are they? I don’t know. Do you know? Can they be fish? Maybe? Maybe fish. I think they are sharks. Maybe they are sharks. That’s right. Now can you put all these back in there for me? This is quite tricky. It is tricky, isn’t it? Do you see that big bench over there, yeah? And we’ll get mum and foster mum to come over as well so they will be there with you and I’ll have a feel of your tummy and a listen to your chest, okay? Yeah? Okay, let’s go. I am just going to have a wee listening into your breathing here, okay? So what we’ll do is I am going go over the top here So can we move Raffy? That’s it. Good girl. Let’s just have a wee listen. Can you lift your chin up for me? That’s it. Well done. You take some big breaths for me. Oh, well done. Well done! All sound absolutely fine. Can you lie down here? Can you rest your head there? I am just going to feel your tummy, okay? You tell me if it is sore when I’m feeling your tummy. Is that ok? Yeah? Did you have your breakfast this morning? What did you have for breakfast? Pancakes. Pancakes! Oh, my goodness! And what was on the pancakes? Butter and jam. Butter and jam! That sounds like a very fancy breakfast, doesn’t it? That’s grand. Okay, I think we can get back down and go look at the toys again. Okay. Well done. Okay, so to check Cora over, she is absolutely fine. I don’t have any concerns about her physical health on examination at all. With all the play exercises that we were doing, there wasn’t anything I was overly concerned about either. Just a few issues with some of the fine motor skills, her using her hands and eye coordination and things like that. But I don’t think it needs any further exploration or referral onto other services. So what I’ll do is I’ll write the report to GP and to social work but we’ll also send a copy to the health visitors and looked after children’s nurses as well. And just ask them to provide additional support or guidance for you as a point of contact, okay? Cora you did really well today. Thank you very much for coming along. And I wish you all the best for the future as well. Thank you. Okay. Bye bye Cora.

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