tegory Sleep Routines
Issue - Pertinent Negative ● Child watches TV every night in his
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room to go to sleep
● Sometimes difficult to wake child up
in the morning
● Sometimes difficult to get child to
sleep
Pertinent Positive ● Sometimes sleeps for 10 hours
● Appears to have routine, including
brushing teeth before bed
Guidelines or Recommendations ● 11-14 hours of total sleep in a 24 hours
period is the recommended amount of
sleep for a child 1-2 years of age,
according to the American Academy
of Sleep Medicine (Paruthi et al.,
2016).
Reference Paruthi, S., Brooks, L., D’Ambrosio, C., Hall,
W., Kotagal, S., Lloyd, R., Malow, B., Maski,
K., Nichols, C., Quan, S., Rosen, C., Troester,
M., Wise, M. (2016). Recommended amount
of sleep for pediatric populations: a consensus
statement of the American Academy of Sleep
Medicine. Journal of Clinical Sleep Medicine,
12(6), 785-786.
Arora T. (2019). Sleep Routines in Children.
Journal of clinical sleep medicine : JCSM :
official publication of the American Academy
of Sleep Medicine, 15(6), 821–822.
https://doi.org/10.5664/jcsm.7826
Professional/Ethical Communication by
Nurse Practitioner to Parent
I know that difficulties surrounding bedtime
can be very frustrating. You should be
comforted to know that sleep resistance is a
very common occurrence among toddlers, and
is often driven by behavior, which can be
corrected with a few changes that do not
require any medications. A consistent
bedtime routine helps to establish sleepiness
cues to your child. Part of this routine can be
reading a book, which you have said your son
enjoys doing. It would be best to remove the
television from your child’s room at this age,
as it can negatively impact sleep. Adequate
amount and quality of sleep is especially
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important in early childhood, as it establishes
healthy habits that are associated with
improved behavior, learning, emotional
regulation, and overall physical health.
Clinical Pearl Issue #2
Category Temper Tantrums and Discipline
Issue - Pertinent Negative ● Mother raising voice to child during
appointment
● Mother states that she repeatedly tells
the child not to touch things, but that
he continues to disobey.
Pertinent Positive ● Mother does not use physical forms of
discipline
Guidelines or Recommendations ● Discipline strategies such as yelling at
children are minimally effective in the
short-term and not effective in the long
term
● Strategies should be tailored to the
developmental stage of the child
● AAP recommends using healthy forms
of discipline which include setting
limits, positively reinforcing desired
behavior, redirecting, and establishing
expectations.
Reference American Academy of Pediatrics. (2018).
Effective discipline to raise healthy children.
Pediatrics, 142(6), pp. 2-5.
Professional/Ethical Communication by
Nurse Practitioner to Parent
You are doing the right thing by refraining
from using physical force to discipline your
son, as it is shown to result in negative future
outcomes for the child, as well as be
ineffective in correcting unwanted behavior.
Yelling is also discouraged as a means of
discipline. Your son is in a stage of
development where he is learning by
exploring. Try calmly redirecting him away
from unsafe or unwanted situations, but also
allow him the opportunity to explore the
world around him in a safe space, so he can
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