Observation Guidelines: Assessing Health Behaviors of Children and Adolescents

Example:

Melissa is a good student, an avid runner, and a member of the student council. She is quite thin but wears baggy clothes that hide her figure, and she eats only a couple pieces of celery for lunch. Her teacher and principal suspect an eating disorder and meet with Melissa’s parents to share their suspicion.

Implication:

Observe what children eat and drink during the school day. Seek free or reduced-rate breakfasts and lunches for children from low-income families. Consult with specialists and parents when eating habits are seriously compromising children’s health.

Physical Activity

Look For:

• Improvements in speed, complexity, and agility of gross motor skills (e.g., running, skipping, jumping)
• Restlessness and fidgeting (reflecting a need to release pent-up energy)
• Bullying and other socially inappropriate behaviors during playtime
• Cooperation and teamwork during organized sports activities
• Overexertion (increasing the risk of injury)

Example:

During a class field day, a fifth-grade teacher organizes a soccer game with her students. Before beginning the game, she asks them to run up and down the field, individually accelerating and decelerating while kicking the ball. She then has them practice kicking the ball in ways that allow them to evade another player. Only after such practice does she begin the game (Logsdon et al., 1997).

Implication:

Incorporate regular physical activity into the daily schedule. Choose tasks and activities that are enjoyable and allow for variability in skill levels. Make sure youngsters have mastered necessary prerequisite skills before teaching more complex skills.

Rest and Sleep

Look For:

• Listlessness and lack of energy
• Inability to concentrate
• Irritability and overreaction to frustration
• Sleeping in class

Example:

A teacher in an all-day kindergarten notices that some of his students become cranky during the last half-hour or so of school, and so he typically reserves this time for storybook reading and other quiet activities.

Implication:

Provide regular opportunities for rest. When a youngster seems unusually tired day after day, talk with him or her (and perhaps with parents) about how lack of sleep can affect attention and behavior. Jointly seek possible solutions to the problem.

Health-Compromising Behaviors

Look For:

• The smell of cigarettes on clothing
• Physiological symptoms of drug use (e.g., red eyes, dilated pupils, tremors, convulsions, respiratory problems)
• Distortions in speech (e.g., slurred pronunciation, fast talking, incoherence)
• Poor coordination
• Impaired decision making
• Mood changes (e.g., anxiety, depression)
• Dramatic changes in behavior (e.g., unusual energy, loss of interest in friends)
• Signs of sensory distortions or hallucinations
• Rapid weight gain and a tendency to wear increasingly baggy clothes (in girls who may be pregnant)

Example:

A school counselor notices a dramatic change in James’s personality. Whereas he used to be energetic and eager to engage in activities, he now begins to “zone out” during counseling sessions. He slumps in his chair, looking down or staring out the window. His limited speech is unintelligible. The counselor suspects drug use and asks him about his demeanor. James denies that anything is wrong, so the counselor confronts him directly about her suspicions, refers him to a drug treatment center, and consults with her supervisor about additional steps to take.

Implication:

Educate children and adolescents about the dangers of substance abuse and unprotected sexual activity; teach behaviors that will enable youngsters to resist temptations, tailoring instruction to their cultural backgrounds. Encourage participation in enjoyable and productive leisure activities that will enable young people to socialize with health-conscious peers. Consult with the counselor, psychologist, or social worker when you suspect that a youngster is pregnant or abusing drugs or alcohol.