Fragmented Content Analysis Quiz

Toddlerhood

• Toddlerhood is the period from 1 to 3 years of age.
• Growth rates of toddlers are slower than those of infants.
• Toddlers develop many new skills, including both fine and gross motor skills related to dressing, feeding, toileting, and walking.
• Another important development in this period is related to language development.
• These newly acquired skills support the toddler's growing independence.
• Head growth slows compared to the growth of the body and extremities.

Objectives

• Define toddlerhood and its physical characteristics.
• Describe developmental milestones (motor, psychosocial, cognitive, moral, and communication).
• Discuss nutritional needs, sleep, play, and safety of toddlers.
• List the nursing role in promoting toddler health.
• Recognize child abuse.

Growth in Toddlerhood

• Height: Toddlers grow an average of 7.5 cm per year. Average height at 2 years is 87 cm, and at 3 years is 95 cm.
• Weight: Toddlers gain an average of 2-3 kg per year. Average weight at 2 years is 12 kg and at 3 years is 14.6 kg.
• Body Proportions: Extremities grow faster than the trunk. This leads to a more proportionate body appearance overall.
• Potbelly appearance: Toddlers may have a noticeable potbelly and exaggerated lumbar curve (lordosis).
• Strength and Posture: By age 3, toddlers are typically taller, more slender, and have stronger abdominal muscles, and better posture.

Bone Development

• Bone growth and development (G&D) gradually slows during toddlerhood.
• Ossification: Cartilage is replaced by bone tissue, with increased density and hardness. This process will be complete by puberty.
• Anterior fontanel closure: By 18 months, the anterior fontanel is typically closed.
• Greenstick fracture: Bones may bend beyond normal limits without breaking completely.

Sensory Development

• Visual acuity improves to 20/20 by the end of toddlerhood.
• Vision can be enhanced with large objects held close.
• Screening for amblyopia (lazy eye) or double vision is important.
• Strabismus (eyes crossing) is apparent.
• Hearing is fully developed in toddlers.
• Eustachian tube (shorter and wider) may lead to ear infections.

Vital Signs

• Heart rate, respiratory rate, and blood pressure readings tend to decrease in toddlerhood.

Developmental Milestones - Motor

• Gross motor skills:
  • 15 months: walking alone without assistance
  • 18 months: creeping up stairs, walking up stairs, sitting on a chair
  • 24 months: running clumsily, climbing stairs using two feet
  • Running with a wide stance
  • Kicking a large ball
  • Walking down the stairs with assistance
  • Jumping on the spot
  • Hopping
  • Standing on one foot
  • Walking on tiptoe
  • Riding a tricycle

Developmental Milestones - Fine Motor

• 15 months: grasp a spoon and insert it in a dish
• 2 years: remove clothing, hold a crayon with fingers, copy a circle or vertical line
• 3 years: build a tower of blocks, turn knobs and open lids, complete simple puzzles.

Toilet Training

• Parental readiness is more important than the child's readiness.
• Toilet training should be a positive experience.
• Successful toilet training is achieved when the child demonstrates maturity in sphincter control, nerves, and language abilities.
• Toddlers achieve daytime dryness before nighttime dryness.
• By 3.5 years, bladder control is usually achieved.

Assessing Toilet Training Readiness

• Physical: voluntary control of anal and urethral sphincters, ability to stay dry for 2 hours, regular bowel movements, fine and gross motor skills, sitting, walking, and squatting
• Mental: recognizing urge to defecate or urinate, verbal or nonverbal communication, cognitive skills
• Psychological: willingness to please parent, sitting on the toilet without fussing, curiosity about toileting habits, impatience when soiled or wet

Psychosocial Development

• Autonomy: Toddlers strive for independence in daily activities (toileting, dressing, feeding, and caring for belongings).
• Ambivalence: Toddlers may exhibit conflicting emotions, such as love and hate, towards caregivers when disciplined.

Discipline

• Discipline should guide, correct, strengthen, and improve the child's choices.
• It should not deny the child freedom.
• Caregivers should be consistent in reinforcing limitations.
• Sometimes discipline can trigger negativistic behavior such as temper tantrums and rebellious behavior ('no').
• Toddlers are eager to take control and independence.

Temper Tantrums

• Tantrums occur when a child's needs aren't immediately met.
• Toddlers have limited vocabulary to express feelings.
• Tantrums may involve kicking, screaming, or holding breath.
• Tantrums are common between ages 2 and 3; frequency and intensity diminish by ages 4 and 5.
• Strategies to manage tantrums include: minimizing focus on minor issues, providing choices, ignoring, time out, positive reinforcement.

Special Psychosocial Concerns

• Separation Anxiety: Parents should be honest in explanations and offer reassurance.
• Regression: Toddlers can regress to earlier behaviors (e.g. bedwetting).
• Comfort Items: Transitional objects (e.g. blanket, soft toy) are important to soothe toddlers.
• Sibling Rivalry: Toddlers may feel jealousy and insecurity sharing parental attention with siblings.

Cognitive Development

• Preoperational thought: Toddlers interpret experiences based on memories.
• Object permanence: Toddlers understand objects exist even when not visible.
• Egocentric: Toddlers view the world from their own perspective and don't consider other viewpoints.
• Time: The concept of time is still developing.

Moral Development

• Moral development is influenced by imitating parental behavior and values.
• Parents should teach toddlers right and wrong.
• Repeated instructions and consistency reinforce moral decisions.
• Learning respect is crucial in this stage.

Communication and Language Acquisition

• Language development is automatic, spontaneous, and improved with practice.
• Toddlers' speech and reading enhance language skills.
• Language development is accompanied by memory and recognition.
• Toddlers use symbolic function, like the word "potty".
• Toddlers use words to express needs (e.g., saying "juice" when thirsty).

Nutritional Needs

• Eating habits established during toddlerhood are lifelong habits.
• Toddlers need a balanced diet that supports muscle and bone growth.
• Limit milk intake to 12 ounces of low-fat milk per day.
• Encourage water intake.
• Food likes and dislikes can influence toddlers' diets.
• Offering small meals and nutritious snacks is important.

Sleep and Rest

• Sleep needs decline but short naps are still important.
• Consistent bedtime rituals like reading enhance security and reduce anxiety.
• Nightmares are common in toddlerhood and should be handled calmly.
• Resolving sleep problems includes establishing a routine and encouraging quiet-time activities.

Play

• Play helps toddlers develop (ego, cognition, socialization).
• Imitative play, like talking on the phone, helps develop social skills.
• Symbolic play, like pretending to feed a doll, is important for development.
• Safe playthings (e.g., tricycles, swings) promote gross and fine motor skills.

Parallel Play

• Toddlers play alongside others without interaction or sharing.

Imaginary Play

• Imaginary play, including imaginary friends or playmates, is common for toddlers.

Electronic Devices, Television, and Toddlers

• Electronic devices provide no sensory stimulation.
• They do not stimulate fine motor skills, and can delay speech development.
• Limit screens and encourage other activities.
• If using electronics choose apps that help development, e.g., drawing, colouring, puzzles.

Safety

• Toddlers are curious and may not perceive danger.
• Parents should provide constant supervision due to their curiosity and inability to recognize danger.
• Important safety precautions include consistent supervision during all activities, motor vehicle safety (car seats, locks), prevention of burns (safe stove knobs, pot handles), play area safety (avoiding roads), prevention of ingesting poisons (cleaning agents, medications), and prevention of choking/drowning hazards.

Health Promotion

• Regular physical examinations are important for monitoring growth and detecting problems.
• Health screening at 18, 24, and 36 months is crucial.
• Ensure appropriate immunizations based on the recommended schedule.

Child Abuse

• Health care workers should be aware of and respond to possible signs of child abuse (physical, psychological, or sexual).
• These workers should assess patients and report suspected cases of abuse.
• Child abuse may involve neglecting, injuring, or harming the child.

Summary

• Toddlers have slower growth rates compared to infants.
• Nurses play a key role in toddler health.
• Healthcare workers and others should respond to signs of abuse.

Review Questions (with answers)

• Which of the following needs is the toddler's motivation to acquire and master most psychomotor skills? Answer: B. Independence
• At what age does a child usually have a complete set deciduous teeth? Answer: D. 30 months
• Which of the following thinking styles is associated with toddlers? Answer: A. Imaginative

Class Discussion

• Parents of a 2.5 year old are concerned their child only says “no’. What advice could you offer?

Test your understanding of fragmented texts and their usability. Analyze the challenges, limitations, and potential results of dealing with incoherent content. Answer questions that explore your ability to infer meaning from incomplete information.