The nurse is doing client teaching with a child who has been placed in a brace to treat scoliosis. Which statement made by the child indicates an understanding of treatment?

A. Scoliosis braces, such as the thoracolumbosacral orthosis (TLSO), are most effective when worn for the prescribed duration, usually 18–23 hours per day. Removing the brace outside of approved times can reduce its effectiveness in preventing curve progression. Temporary removal due to fatigue is not recommended.

B. Most scoliosis braces need to be worn for several years or until skeletal maturity is reached, depending on the severity of the curve. Expecting only 6 months is a misconception and indicates a lack of understanding about the long-term nature of treatment.

C. Braces should not be removed for social events. Compliance is crucial for treatment success. This statement reflects misunderstanding of the importance of consistent brace use.

D. Approved brief removal of the brace for hygiene purposes is acceptable and safe. This statement demonstrates that the child understands the proper use of the brace, including that removal should be limited and purposeful, and that the brace should otherwise be worn as prescribed to manage scoliosis effectively.

A. This is a form of regression is incorrect because regression involves reverting to behaviors from an earlier developmental stage (e.g., bedwetting or thumb-sucking) often triggered by stress or illness. Having an imaginary friend is a normal developmental behavior in preschoolers and is not considered regression.

B. Preschool-aged children (ages 3–6) are in Piaget’s preoperational stage and Erikson’s initiative vs. guilt stage, during which imaginative and symbolic play is typical. Imaginary friends are a common expression of magical thinking and creativity, allowing children to explore social roles, practice problem-solving, and express emotions in a safe, controlled way. This behavior is developmentally appropriate and usually does not indicate a psychological problem.

C. Inclusion of imaginary friends may indicate lack of parental attention is incorrect because the presence of imaginary friends is not a sign of neglect or lack of attention. It is a normal aspect of imaginative play, even in children who receive adequate parental interaction and support.

D. She needs to seek psychiatric help for her daughter is incorrect because the presence of an imaginary friend in a preschooler is not pathological. Unless accompanied by other concerning behaviors (e.g., social withdrawal, aggression, developmental regression), it is considered a normal developmental phenomenon.