Parents of a 5-year-old child tell the nurse they are concerned about their child's speech development by stating "No one can understand him but us.”. What clinical classification of speech disorder does the nurse suspect?

Choice A rationale:

Young children often understand that other people die, but do not equate it with themselves. Young children typically begin to grasp the concept of death, but they often don't fully understand it in the same way adults do. Their understanding of death tends to be more external, and they may not relate it to themselves. The nurse's response should be guided by this understanding because it helps in communicating with and supporting children when they encounter the death of a loved one. By recognizing that children may not see death as an immediate threat to themselves, the nurse can provide age-appropriate explanations and reassurance, addressing the child's concerns and fears. It's crucial to be sensitive to the child's emotional state and offer comfort and support as needed.

Choice B rationale:

Children can understand the concept of a higher being much like adults can. While children may have some understanding of the concept of a higher being, their understanding is often simpler and less abstract than that of adults. It's important for the nurse to acknowledge a child's spirituality and beliefs when discussing death, but it's not the primary understanding that guides the nurse's response. The primary focus should be on the child's understanding of death itself and how it may affect them or their loved ones.

Choice C rationale:

The children's response will depend entirely on whether they have been acquainted with death before this. While prior exposure to death may influence a child's response, it is not the sole determining factor. Even children who have not experienced death before may still have various emotional reactions when a loved one dies. The nurse should approach each child individually, taking into consideration their unique experiences and emotions rather than relying solely on past exposure to death.

Choice D rationale:

Children are unlikely to notice their grandmother's absence if no one reminds them. This choice is not an appropriate understanding to guide the nurse's response. Children are likely to notice the absence of a loved one, especially a grandmother, regardless of whether someone reminds them. They may not fully understand the implications of death, but they will notice the change in their daily life and routines. It is essential to support and communicate with them during this period rather than assume they won't notice the absence.

Choice A rationale:

Articulation disorder refers to difficulty in pronouncing sounds and is more related to the physical aspects of speech production. The scenario described by the parents focuses on the comprehensibility of the child's speech, not the specific pronunciation of sounds.

Choice B rationale:

Global language delay typically involves a delay in both expressive and receptive language skills. However, the parents' concern about their child's speech not being understood by others suggests that the issue is more specific to expressive language, which involves the ability to convey thoughts and ideas.

Choice C rationale:

Expressive language delay refers to difficulties in using language to express thoughts and ideas. In this case, the parents mention that "No one can understand him but us," indicating that the child has trouble communicating effectively with others, which aligns with an expressive language delay.

Choice D rationale:

Language loss is not a likely consideration in this scenario as the parents are concerned about their child's current speech development, not a regression in language skills.