Understanding Growth and Development

Role of the PSW

• PSWs provide care to clients in different stages of their development.
• Understanding human growth and development aids PSWs in identifying and meeting client needs.

Principles of Growth and Development

• Growth refers to measurable physical changes occurring steadily.
  • It is typically measured by weight and height and encompasses changes in appearance and body functions.
• Development involves changes in mental, emotional, and social functions, influencing behavior and thinking.
• Maturation signifies completed growth and development.
• Growth and development, though distinct, overlap, depend on each other, and occur concurrently.
• The growth and development processes begin at fertilization and continue until death.
  • They progress from simple to complex and unfold in specific directions, sequences, orders, and patterns.
  • These rates are uneven and each stage has unique characteristics and developmental tasks.
• Skipping stages is not possible because each stage lays the foundation for the subsequent one.
• Growth is most rapid during infancy.
• Individuals may not always align with developmental "norms" for their age.
• The pace of development is influenced by various factors, including nutrition and the environment.

Factors Influencing Growth and Development

• There are three main categories: genetic factors, environmental factors, and interacting factors.

Genetic or Natural Factors

• Heredity determines various traits like sex, skin/hair/eye color, physical growth, stature, and psychological uniqueness.
• Temperament describes the innate psychological disposition of a child, ranging from difficult to flexible, affecting interactions with the environment.

Environmental Factors

• Family protects, teaches, and nurtures its members, fostering survival, security, and social/emotional development.
  • Family influences values, beliefs, customs, interaction, and communication.
• Peer Groups provide a new learning environment with different patterns of interaction, allowing learning about success and failure.
  • They validate/challenge ideas and allow one to receive acceptance/rejection.
• Health Environment influences responsiveness to the environment and others.
  • It determines availability and accessibility to resources.
• Nutrition is regulated by dietary factors. Its adequacy affects how physiological and developmental needs are met.
• Rest, Sleep, and Exercise balance is essential for rejuvenation, while disturbances can diminish growth, with equilibrium reinforcing health.
• Living Environment includes weather, community, socioeconomic status, and environmental quality.
  • Embryos exposed to teratogens may experience abnormal development.
• Political and Policy Environment: Municipal, provincial, and federal policies directly affect individuals, families, and communities.

Interacting Factors

• Life Experiences: Individuals develop based on past learning, with experiences emerging from both biological and environmental sources.
• Prenatal Health: Biological and environmental factors such as genetics, maternal health, substance use, and prenatal services all affect fetal development.
• State of Health: Overall health depends on biological factors, environmental circumstances, and access to resources.
  • Health changes from illness or injury may disrupt development.

Developmental Theories

• Theory: A logical set of statements explaining a subject.
• Human Developmental Theories: Models explaining how and why people develop.
• Theories help healthcare professionals understand developmental milestones to care for patients

Erikson's Developmental Theory

• Erikson expanded Freud's theory by including the entire human lifespan and emphasizing socialization.
• Each person progresses through eight stages, accomplishing a task before advancing.
• Each stage builds on the successful resolution of prior conflicts, with mastery leading to challenges in new situations.

Erikson's Stages of Development

• Stage 1: Trust vs. Mistrust (Infancy: birth to 1 year)
  • Infants learn to trust others through consistent caregiving, answering "Can I trust the world?".
  • Parents can struggle with competence but PSWs can direct resources
• Stage 2: Autonomy vs. Shame and Doubt (Toddler: 1-3 years).
  • Toddlers learn to be independent, developing confidence in controlling their own behavior.
  • Nurses and PSWs can use empathetic guidance to offer support and understanding.
• Stage 3: Initiative vs. Guilt (Preschool: 3-6 years).
  • Children learn to initiate activities, exploring limits.
  • Impulse control is necessary at this stage.
• Stage 4: Industry vs. Inferiority (Middle Childhood: 6-11 years).
  • Children learn to develop competence in physical, cognitive, and social areas through experiences.
  • Introduce children to a variety of interests.
• Stage 5: Identity vs. Role Confusion (Adolescence: 12-20 years).
  • Adolescents experiment with roles to form identities and are faced with physical and emotional changes.
  • Offer support through education to help deal with said changes.
• Stage 6: Intimacy vs. Isolation (Young Adulthood: 20-40 years).
  • Young adults must form personal relationships to avoid isolation.
  • Understanding that during hospitalization, young adults may benefit from partner support.
• Stage 7: Generativity vs. Stagnation (Middle Adulthood: 40-65 years).
  • Middle-aged adults should help younger people to avoid stagnation.
  • Assists with social development to offer fulfillment from volunteering or local community centers.
• Stage 8: Integrity vs. Despair (Old Age: 65+ years).
  • Older people are meant to reflect on their life and avoid despair on life and death.
  • Provide support, encourage volunteer work.

Piaget's Theory of Cognitive Development

• Jean Piaget (1896-1980) studied how people understand their world.
• It studies the development of children's thinking organization, reasoning, and perception.
• Includes 4 periods that range in stage where all people are theorized to move through at different rates
• Piaget theorized this to be true of all cultures, that maturation and intellectual stimulation play a role
• Children acquire knowledge from the interactions with their environment

Piaget's Periods of Cognitive Development

• Period 1: Sensorimotor (Birth to 2 years).
  • Infants learn through movements and actions like sucking, grasping, looking, and listening.
  • Infants discover that thing exist even they can't be seen (like object permanence)
• Period 2: Preoperational (2 to 7 years).
  • Children begin to think symbolically with pictures and words.
  • During this stage, children are egocentric and struggle to understand perspectives of others.
• Period 3: Concrete Operations (7 to 11 years).
  • Children think concretely and begin thinking logically about real events.
  • Here, children understand the concept of conservation, the change of an object doesn't change the object.
• Period 4: Formal Operations (11 years to adulthood).
  • Individuals think abstractly and move into theoretical subjects like the meaning of life.
  • They understand complex problem solveing.

Maslow's Hierarchy of Needs

• Maslow, an American psychologist, theorized human needs in a hierarchy.
  • A human need is deemed necessary or desirable to maintain life.
• Basic needs must be met for a person to survive
• A hierarchy shows the importance of most basic to higher needs

Levels of Maslow's Hierarchy of Needs

• From lowest to highest
  • Physiological (food, water, sleep)
  • Safety (safe environment)
  • Love and Belonging (tenderness and devotion)
  • Self-Esteem (feeling well and helpful)
  • Self-Actualization (reaching potential)

Types of Needs

• Physical: most essential needs (food, water, sleep for homeostasis).
• Safety: the need to feel safe regardless of age; prevalent during war or disasters.
• Love and Belonging: the deep need of emotion to avoid feeling lonely or rejected.
• Self-Esteem: Esteem, one's value or opinion, brings feelings of confidence/usefulness, but unmet needs can result in inferiority/depression.
• Self-Actualization relates to realizing potential through learning and understanding, with the majority attempting to learn more.

Infancy (Birth to 1 year)

• The first year is characterized by rapid physical, psychological, and social growth.
• Developmental tasks during this period:
  • Learning to walk
  • Learning to eat solid foods
  • Beginning to talk and communicate with others
  • Learning to trust
  • Beginning to have emotional relationships
  • Developing stable sleep and feeding patterns

Neonate or Newborn

• The neonatal period is the first 28 days after birth.
• During this period, the baby is called a neonate or newborn.
• The average newborn:
  • Has an average length of 48-53 cm (19-21 inches)
  • Weighs between 3200-3600 g (7-8 lb)
• Genetics and ethnicity influence differences in birth weight, length, and head circumference.
• Birth weight usually triples by the first birthday.
• Newborns have wrinkled skin and underdeveloped central nervous systems.
• Movements are uncoordinated and lack purpose.
• A newborn's head is large compared to the rest of its body.
• Trunk is long, the abdomen is large, round, and soft.
• Newborns have larger cheeks, a flat nose, and a receding chin.
• Newborns can see at birth, but vision is not clear.
• For the first six months, their diet consists primarily of breast milk or formula.
• Solid foods are usually added at 5-7 months.
• Allergies to food products should be monitored when solid feeds are introduced.
• Newborns hear well and react to touch and pain.
• They can taste and smell.
• Newborns have certain reflexes
  • Moro reflex (startle reflex) occurs when startled by a loud noise; the arms are thrown apart, the legs extend, and the head is thrown back.
  • Rooting reflex occurs when the cheek is touched near the mouth causing the head to turn toward the touch; it helps guide the infant's mouth to the nipple; sucking also occurs.
  • Grasping (palmar) reflex occurs when the palm is stroked causing the fingers to close around the object; it declines around the second month and disappears by the third month.

Infant Development Milestones

• 1 month: can hold head up
• 2 months: smile, follow movement of objects
• 3 months: raise their heads and shoulders when lying on their stomachs
• 4 months: able to roll over and can sit up if supported; Moro and rooting reflexes disappear; hold objects in both hands
• 5 months: hold objects with both hands and put objects in their mouth; can grasp objects and play with their toes
• 6 months: two lower front teeth come in; begins to chew, hold bottle, sit alone
• 7 months: upper teeth start to erupt; can say "dada” and/or "mama”, fear strangers
• 8 months: may be able to stand, respond to the word “no”
• 9 months: can crawl, finely chopped foods added to diet
• 10 months: understand a number of words, can walk around while holding onto furniture
• 11 months: may begin to take a few steps
• 1 year of age:
  • Many start to walk and can hold a cup for drinking
  • Know more words and can say “no” and shake their heads
  • Play by themselves with their own toys, solitary play

Infant Diet

• During the first 6 months, the infant's diet is mainly breast milk or formula.
• Solid foods (strained fruits and vegetables) are usually added at 5-7 months; health care provider will advise dietary changes.
• Chopped foods are added during the ninth and tenth months, and a 1-year-old can eat table foods.

Infant Safety and Security

• Infants are helpless and depend on others for their basic needs.
• Support worker must ensure their safety and meet both their physical and emotional needs.
• Practice proper hand hygiene.

Comforting a Crying Infant

• Babies cry to communicate when wet, hungry, hot or cold, tired, uncomfortable, or in pain.
• Respond to the baby's crying immediately to help the baby feel safe and secure; you cannot spoil an infant with too much attention and comfort.
• Guidelines for soothing a crying infant
  • Ensure all physical needs are met
  • Use gentle motions, such as rocking, swinging, or walking back and forth
  • Hold the baby close to the chest so that the baby can hear the heartbeat
  • Rub the baby's back or stomach
  • Swaddle the baby

Holding an Infant

• Pay particular attention to hygienic measures.
• Handle a baby with gentle, smooth movements.
• Avoid sudden or jerking movements as they can startle or upset.
• Use both hands to lift a newborn and always support the newborn’s entire body, especially their head.
• Don’t let arms or legs dangle.

Bottle-Feeding

• Formula comes in three forms:
  • Ready-to-feed
  • Powdered
  • Concentrate
• Bottles are prepared one at a time or in batches for the whole day
  • Follow the container directions and use bottles stored in the refrigerator within 24 hours
• Protect the baby from infection by washing formula containers before opening them.
• Baby bottles, caps, nipples, and other items must be as clean as possible, ideally sterilized before use.
• Bottle-feeding the infant
  • Fed every 3-4 hours
  • Do not like cold formula
  • Warm the bottle in a bowl of warm water, or hold it under warm, running tap water
  • Test the temperature, sprinkle a few drops on the inside of your wrist; the formula should feel warm

Burping the Infant

• Babies ingest air during feedings, which causes cramping and discomfort that may lead to vomiting.
• Burping helps to get rid of the air.
• Burp babies midway and after a feeding, pat or rub the baby’s back with circular motions for 2 to 5 minutes.
• Position the baby for burping in one of the following ways
  • Over your shoulder with a clean diaper or towel over your shoulder
  • Support the baby in a sitting position on your lap with the towel or diaper in front of them, remember to support the infant’s head and neck for the first 3 months after birth.
  • Position the baby on your lap with their stomach down, place a clean diaper or towel on your lap where the baby’s head will be.

Diapering

• In breastfed babies, stools are yellow and the consistency of scrambled eggs.
• In bottle-fed babies, stools are yellow to brown and firmer.
• Over time, an elimination pattern develops.
• Stools are usually soft and unformed.
  • Hard, formed stools may signal constipation.
  • Watery stools may indicate diarrhea, both are issues that require immediate attention.
• Diapers are changed when wet or when stools are present.
• To care for cloth diapers, the following steps are taken:
  • Rinse the soiled diaper in the toilet, storing it in a diaper pail.
  • Wash them daily or every 2 days separately from other laundry items in hot water with baby laundry detergent
  • Put them through the wash cycle a second time without detergent and dry thoroughly before folding.
• Securing disposable diapers are secured with Velcro or tape strips.
• Fold soiled diapers and discard into the garbage; never flush.
• Changing diapers often helps prevent diaper rash.
• Clean and dry the baby before applying a clean diaper.
• Notify the nurse immediately if a diaper rash develops.

Bathing an Infant

• A bath provides hygiene, good skin care, comfort, relaxation, time to hold, touch, talk, and stimulation.
• Planning for the bath is important; never leave the baby alone.
• Two bath procedures
  • Sponge baths are given for the first 2 weeks.
  • Tub baths are used after the cord site or circumcision site has healed.
• Some provinces allow all babies to be bathed in a shallow tub of water; always check the employer’s policy.

Laying the Infant Down to Sleep

• Ensure safety precautions are taken to prevent sudden infant death syndrome (SIDS).
• Always lay babies on their backs for sleep.
• Babies who sleep on their stomachs or sides have an increased risk of SIDS, unless specific medical conditions require this; consult the plan of care.
• Babies can lie on their stomachs when they are awake and supervised (tummy time).
• Do not lay the baby on soft bedding products; these include fluffy, plush products such as sheepskin pillows, quilts, comforters, memory foam mattresses or mattress pads, or soft toys which can cause suffocation as the soft bedding can cover the baby's nose and mouth.
• Make sure the baby is warm but never hot.
• Overheating increases the risk of SIDS; avoid overdressing at bedtime.
• Check the baby's temperature, your hand on the back of the baby's neck; if the neck is sweaty, the baby is too warm.

Shaken Baby Syndrome

• Defined as the physical and cognitive impairments caused by violently shaking a baby or young child.
• Babies and young children have weak neck muscles, and shaking them violently causes the head to swing back and forth with great force.
• Brain hits against the skull wall, causing bleeding behind the eyes and in the brain.
• Can result in permanent brain injury, seizures, partial or total blindness, paralysis, intellectual disability, or death.
• Less violent but frequent shaking of a young child can also cause long-term effects, including attention deficits and learning disabilities.

Preventing Falls in Infants

• Falls are the leading cause of injuries and death in children. -Infants can roll off a table or fall downstairs -Falling out of highchairs or infant seats and falling down the stairs are also common accidents.
• Take the following safety measures to prevent falls: -Do not leave infants and young children unsupervised on high surfaces. -Secure the child in a highchair or infant seat using both straps. -Lock the highchair tray after securing the child in the chair. -Keep highchairs away from counters to prevent child from pushing off. -Do not use baby walkers, they cause many serious falls; use safety gates at the top and bottom of stairs. -Keep one hand on a child lying on a scale, bed, change table, or other furniture or when changing diapers and keep supplies within easy reach. -Keep crib rails up and in the locked position and check children in cribs frequently. -Make sure there is nothing in the crib that the baby can stand on to prevent them from falling over railing.

Ways to Prevent Choking

• Always supervise children when they are eating and preparing and ensuring food is small.
• Grate, mash, blend, or chop food into very small pieces before giving it to a baby.
• Do not give infants and young children hot dogs, raw carrots, peanuts, popcorn, whole grapes, raisins, hard candy, or gum.
• Do not prop bottles on a rolled towel or blanket, hold the baby and the bottle during feedings.
• Check for small objects such as coins, buttons, marbles, pins, and paper clips on the floor, they can cause choking.

Protecting Children from Burns

• Do not drink or carry hot liquids near infants and children, make sure children are not in your way when carrying anything hot.
• Do not heat a baby bottle or baby food in a microwave oven, always shake the bottle or stir the food and test the temperature before giving it to the baby.
• Keep hot foods and liquids away from counter and table edges, and do not use tablecloths or placemats.
• Always test the temperature of the bathwater before bathing a child, position facing away from water faucets, and do not let touch handles.

Toddlerhood (1 to 3 Years)

• Growth rate is slower than during infancy.
  • Developmental tasks include tolerating separation from the primary caregiver.
  • Other milestones include gaining control of bowel and bladder function.
  • Toddlers use words to communicate and become less dependent on the primary caregiver.
• Toddlers need to assert independence.
• Curiosity is demonstrated as they touch, smell, and taste everything within reach.
• Exploration of the world occurs as they become more coordinated and learn new skills.
• By 3 years old, a toddler can run, jump, climb, ride a tricycle, and walk up and down stairs.
• Toilet training requires the child to be psychologically and physically ready.
  • Bowel Training is generally easier than bladder training, and is often completed by 2.5 years.
  • Daytime bladder control is typically achieved before nighttime control.
  • Bladder training is usually complete around 3 years old.
• There are increased speech and language skills.
  • Toddlers are able to form 2-3 word sentences.
• Play ability increases.
  • A 2-year-old often engages in parallel play, playing alongside other children but not necessarily with them.
  • The word "mine" is frequently used.
• Temper tantrums and saying "no" are common.
  • This stage is also called the "terrible twos".

Preschool (3 to 5 Years)

• Preschoolers are thinner, more coordinated, and more graceful than toddlers.
  • Increase in ability to communicate and understand others.
  • Begin performing self-care tasks like putting on shoes, dressing, and managing buttons.
  • Start learning differences between genders.
  • Begin learning right from wrong and good from bad.
  • Start learning to play with others.
  • Development of family relationships occurs.

The 3-Year-Old

• Coordination starts to become more refined.
• Personal care skills increase.
• Language skills increase.
• Play is important.
  • 3-year-olds play well with other kids, enjoy role-playing games, and have vivid imaginations.
• Cooperation and sharing skills develop.
• Knowledge of the existence of two sexes.
• Concept of time starts developing.
• May fear darkness and require night-lights.
• Typically demonstrate less fear of strangers.
• Often try to please primary caregivers.

The 4-Year-Old

• Capable of hopping, skipping, and throwing a ball.
• Develops increased curiosity and asks many questions.
• Can draw faces, copy a square, and attempt to print letters.
• Tend to tease, tattle, and exaggerate stories.
• Able to play with other children.
• Play in groups of two or three and may exhibit bossy behavior.
• Can tell stories, with their language skills increasing.
• They may express curiosity about sexuality and start asking how babies are made.
• A preference for the parent of the opposite sex may be observed.
• Rivalries with siblings are often present.

The 5-Year-Old

• Coordination increases
  • Can jump, skate, tie shoelaces, dress and bathe.
• Drawing skills improve.
• Communication skills increase, shows responsibility and truthfulness.
  • Enjoys having rules and eager to do things the right way
• Decreased amount of fears.
  • Experiencing common nightmares and dreams
• Proud of their accomplishments.
• Imitates adults during play and is interested in TV.
• Enjoys doing things with the primary caregiver of the same sex.
  • Activities include cooking, shopping, house cleaning, yard work, and sports.
• Younger children are considered a nuisance.

Middle Childhood (6 to 8 Years)

• School experiences mark the beginning of this stage.
  • Children enter peer groups, engaging in games and learning.
• Developmental tasks include developing social and physical skills for playing games. -Learning to get along with peers of the same age and background.
  • Learning gender-normative behaviors and attitudes.
  • Acquiring basic reading, writing, and arithmetic skills.
  • Developing a conscience and morals.
  • Fostering a positive self-image and attitude

The 6-Year-Old

• Baby teeth are lost, and permanent teeth begin to erupt.
• Children at this stage are highly active and skilled at running, jumping, skipping, hopping, and riding a bicycle.
• Displays bossy, opinionated, charming, and argumentative behaviors, being described as "know-it-alls".
• Prefers having their way, and may cheat to win or quit if losing.
• Starts preferring playing with children of the same sex.
• Vocabulary expands, knowing the alphabet and beginning to read and spell.
• May have a "best friend".

The 7-Year-Old

• Hand coordination increases.
• Spends more time alone and appears quieter.
• Becomes more serious, less stubborn, and concerned about being well-liked.
• Reading skills improve.
• Can tell time.
• Enjoys playing games with rules, swimming, biking, working on puzzles, and playing video games.

The 8-Year-Old

• More permanent teeth appear.
• Movements are faster and more graceful.
• Peer group activities and opinions gain importance.
  • Eagerness to be accepted by peers.
• Boys and girls tend to engage in separate play.
• Displays defensive, opinionated, practical, and outgoing traits.
• Offers advice but does not accept criticism well.
• Expects greater privileges than younger siblings.
• Shows curiosity about science, history, and places.

Support Worker Responsibilities

• Provides a stable, secure, and safe environment for the family.
• Develops positive relationships with all family members.
• Maintains the existing rules of behavior.
• Maintains daily routines as much as possible.
• Remains alert to situations that may create stress or harm to the family. –Refer to the "Think About Safety" box: Family Situations That Must Be Reported (p. 1010).

Meeting Nutritional Needs

• Children require proper and nutritional food to grow and develop each body system to Its maximum potential.
• Getting children to eat properly is an ongoing challenge.
  • Support workers should be aware of the nutritional challenges faced by children in Canada.

Meeting Nutritional Needs: Challenges

• Physical or developmental challenges.
• Family situation may create a stressful working environment for support workers.
• Children living in poverty.
• School-aged children who are often alone -- "latch-key" kids.
• Obesity.
• Self-esteem issues.
• Cultural diversity.

Helping a Child Eat Well

• The family should try to eat meals together.
• The meal table should be viewed as a positive, conflict-free zone, reserving difficult discussions.
• Elimination of distractions such as TV, toys, or phones.
• Practice proper table manners and respectful behavior.
• Allow children to make choices, giving them the opportunity to self-correct their eating habits.

Adjusting Your Approach Based on Child's Age

• Introducing new foods encourages a love of variety, texture, and taste.
• It's normal to present new or different foods up to 15 times before a child is comfortable with it.
• Introduce new foods in a relaxed manner without pressure.
• Discuss any concerns about a child’s eating habits with your supervisor.
  • Especially important if there’s a major change in appetite or weight.
• Be alert to other concerns.
  • Eating issues turned mealtimes into a battleground
  • Eating disorders

Specific Expertise: Assistance from

• Registered dietitians.
• Pediatricians.
• Therapists and counselors.
• Psychiatrists.
• Pediatric gastroenterologists.
• Pediatric endocrinologists.

Protecting Children From Injury

• Support workers ensure the safety of children is always being maintained, regardless of age.
• Injuries like accidents, falls, choking, burns, abuse, and poisonings, are the leading cause of death in children over 1 year old.
  • Injuries also lead to more deaths and disabilities in children than all other causes of disease combined.
• Accidents remain one of the primary causes of death for children over the age of one in Canada despite safety efforts.
  • Common accidents include motor vehicle collisions, falls, poisoning, drowning, suffocation, fire, and being struck by an object.

Consumer Product–Related Injuries

• Data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) analyzed consumer product-related injuries in children:
  • Bunk beds are associated with falls and strangulation.
  • Magnets: Over half of the ingestion incidents involved a magnet.
  • Baby walkers: 88.8% of children in baby walkers who fell down stairs or from a height sustained head injuries. 8.2% required admission to hospital.
• Other Household Products
  • Trampoline-related injuries.
  • Drowning and Near-drowning: May occur with the child left unattended in bath seats or near the pool.
  • Children playing around dangling blinds or curtain cords are exposed to a strangulation hazard.

Risk Factors for Childhood Injuries

• Sex: The majority of injured children are males, due to the prevalence of behavioral characteristics.
• Temperament: Highly active children are exposed to a greater risk for injury.
• Stress.
• History of previous injury.
• Developmental characteristics
  • Natural curiosity to explore the environment.
  • Desire to assert self and challenge rules.
• Cognitive characteristics (age-specific):
  • Infant: This age group explores the environment through taste and touch. Which may lead to accidental poisonings or burns.
  • Young Child:
    • Tends to actively search for attractive objects.
    • Is unaware of "cause and effect" (consequential) dangers.
    • Might fail to learn from experiences.
    • Cannot comprehend dangers to themselves or others.
  • School-Aged Child:
    • May be generally unable to comprehend “cause and effect”.
    • May attempt dangerous acts without thinking of the consequences.
• Anatomical Characteristics (especially in young children):
  • Large Head: Predisposes to cranial injury.
  • Large Spleen and Liver: Predisposes to trauma in these areas.
  • Small and Light Body: May be thrown easily.
  • Left-Handedness: The environment (things built for people who use their right hand) make left-handed persons more prone to injury.

Preventing Falls in Children

• Falls are a leading cause of injuries and death in children.
• Increased risk during times of stress or changes in family routine.
• Always be aware of possible dangers.
• Do not let children under 6 years of age sleep or play on the top bunk.
• Keep children away from windows.
• Do not put furniture underneath or near windows.
• Do not let children run with objects in their hands or mouths.
• Take measures to prevent furniture from falling on children (TVs, bookcases, etc).

Ways to Prevent Choking in Children

• Do not let children blow balloons or put one in their mouths, dispose of broken pieces.
• Keep plastic bags and wrappings away from children.
• Do not let children wear necklaces, strings, cords, or other items around necks.
• Remove or tie up cords or drawstrings on clothing.
• Keep cords for blinds and curtains out of reach.
• Always supervise children in or near water.
• Never leave children unattended in a vehicle.

Protecting Children from Burns

• Burns are a prominent cause of illness and death among children.
  • Heat liquids often cause childhood burns.
• Never leave a "live" extension cord lying around.
• Put safety plugs in all unused electrical outlets.
• Keep pot handles turned toward the back of the stove, utilizing back burners.
• Do not allow young children help cook on stove.
• Do not let electrical cords from irons, coffee pots, toasters hang down.
• Do not let children to play near hot stoves, space heaters, fireplaces, and other heat sources.

Preventing Poisoning

• Very young children put objects in their mouths while learning.
• Poisonings are most common between ages 1 to 4.
• Causes Include:
  • Eating substances such as medications, cigarette butts, and vitamin pills.
  • Drugs and household products

Discipline

• Discipline involves setting limits and providing guidelines to facilitate responsible behavior in an appropriate way.
• Know what acceptable behavior looks like in each family situation.
• Ask a family member if unsure about the behavior.
• Reinforce rules.
• Praise the effort made by children to follow the rules.
• Consistency with rules.
• Punishing children is not the responsibility of the PSW.

Supporting the Child who Demonstrates Challenging Behaviours

• Emotions like anger, frustration, fear, guilt, or shame will be evident in Children.
• Causes can include:
  • Too many life changes.
  • Painful losses.
  • Problems at school.
• Support workers' care will be non-judgemental and a manner to support them.
• "Twelve Principles for Supporting a Child who Displays Challenging Behaviours" (p. 1012)

Preventing Infections

• Children's immune systems are still developing.
• Exposure to a multitude of germs develops resistance to infection.
  • Large groups increase the risk of illness.
• Children that have physical or developmental delays are prone To infectious illness.
• Proper hand and hygiene practices are most important.

Prevention of Childhood Infections

• Washing your hand frequently and thorough is the single best thing anyone can do to stop the spread of illness.
• Soap and warm water for 20 seconds washes your hands. Should be as long as it take to sing Happy Birthday Twice.
• Alternatively use alcohol-based hand sanitizers.

Keeping Child Home From School

• Children who have the following should not be sent to school. -Streptococcal Throat -A return may happen following 24 hours on antibiotic treatment or conjunctivitis: Has antibiotic eye drops or ointment. * Pink eye or bacterial form. -A fever above 38° C. -Experiences of diarrhea and vomiting -Has a positive test for COVID-19 or contact with a person who is positive for COVID-19.

Why Children Miss School

• Upper Respiratory Infections (URIs) (colds)- More severe symptoms that last longer than an adult.
• Stomach Flu (Gastroenteritis)- Concern with dehydration, Drink an oral rehydration solution like Pedialyte
• Ear Infections (Otitis Media)- Colds or allergies trap fluid and cause congestion in the middle ear.
• Pinkeye (Conjunctivitis)- Is quite Contagious; the white part of the eye is itchy, red, and swollen; Antibiotic eye drops or ointments are necessary.
• Sore Throat (Strep Throat): Sore throat is triggered by bacteria called streptococcus. It is painful to swallow Antibiotics are necessary and If it is neglected, It may induce rheumatic fever and heart valve damage or swollen joints.