Toddler Development: Physical, Cognitive, and Psychosocial - PNH 101

Slide 1: Week 5 PNH 101 Toddler This slide simply introduces the topic of the week: Toddlers! We\'re focusing on children aged 1 to 3 years. Slide 2: Week 5 Learning Objectives & Readings Toddler -- 1 to 3 year Learning Objectives: The core objective is to understand the physical, cognitive, and...

Slide 1: Week 5 PNH 101 Toddler This slide simply introduces the topic of the week: Toddlers! We\'re focusing on children aged 1 to 3 years. Slide 2: Week 5 Learning Objectives & Readings Toddler -- 1 to 3 year Learning Objectives: The core objective is to understand the physical, cognitive, and psychosocial development of toddlers, as well as their health risks, concerns, and health promotion strategies. Readings: This slide directs us to specific pages in a textbook, which are not provided. But we have other helpful materials that we can use to understand this developmental stage. Slide 3: Toddler Hood: Age range 12mos to 36mos This slide highlights the age range of toddlerhood, which is 12 to 36 months. It poses two key questions for consideration: What are the developmental changes that allow a toddler to participate in their own care and desire for independence? During this stage, toddlers develop rapidly in their motor skills, which allow them to begin engaging in self-care activities such as feeding, dressing, and toileting. They also become aware of their ability to control their environment and they get pleasure from accomplishing tasks. This success fuels their desire for more independence, which can also lead to frustration and tantrums when they are restricted. How does the nurse take into consideration the developmental changes to guide her nursing care? Understanding these developmental milestones is crucial for nurses to provide appropriate care, teaching, and support to toddlers and their families. This includes patience, consistency, and a non-judgmental approach when toilet training as well as understanding the child\'s need for independence, such as allowing them to dress or feed themselves, while keeping them safe. In a clinical setting, it would be important to minimize separation anxiety and fear, reduce physical discomfort and incorporate play into the nursing care. Slide 4: Toddlers Transitions to Early childhood This slide lists major challenges that occur during the toddler stage that can act as transitions into early childhood. These include: Speech: Toddlers rapidly develop their language skills. An 18-month-old may use around 50 words, while a 24-month-old could have a vocabulary of up to 200 words and start using two-word sentences. Locomotion: Toddlers\' gross motor skills advance rapidly, from unsteady walking to running, jumping, and climbing. Sleep pattern: Toddlers require 11--14 hours of sleep per 24 hours, including naps. Toilet training: This is a key developmental task that requires the toddler to have the physical and cognitive ability to recognize the urge to urinate and defecate. Temper/frustration, obstinacy: Toddlers often exhibit temper tantrums and negativity as they assert their independence and struggle with limitations. Independence; daycare/play school: Toddlers become more independent and may start attending daycare or play school, which introduces new social interactions. "The terrible twos": This phrase highlights the challenging but normal period of testing boundaries and asserting independence. Intense period of exploration: Toddlers are naturally curious and explore their environment, which is crucial for their development. Slide 5: Physical development of the toddler This slide covers the physical development of the toddler, emphasizing the following: Steady growth, not linear: Toddlers grow at a slower pace compared to infancy. Weight gain slows: Toddlers gain about 4-6 pounds per year. Height increases: Toddlers grow approximately 3 inches per year. Bone growth continues: The skeletal system continues to develop. Birth weight quadrupled by 30 months: This is a significant milestone in weight gain. By 2.5 years, a child\'s weight is generally four times their birth weight. Anterior fontanel closes: This closure occurs between 12 and 18 months. Myelination of the spinal cord: Myelination is completed by 2 years of age, which is crucial for the development of control over anal and urethral sphincters, and thus for successful toilet training. Respirations shift: Breathing shifts from primarily abdominal to more thoracic. Eustachian tube: The eustachian tube is shorter and straighter than in adults, making toddlers more susceptible to ear infections. Eruption of deciduous teeth: The full set of primary teeth is usually complete by 2.5 years of age. Teeth brushing and oral care: This is an important part of routine care during toddlerhood to maintain good oral hygiene. Slide 6: Gross Motor Development Toddler This slide focuses on gross motor skill development: Locomotion is the major gross motor skill: Toddlers are constantly moving and exploring. Gait changes: Walking develops from a wide, unstable gait to running, climbing stairs, and riding tricycles by age 3. Skills by age 2: By age 2, toddlers can often stand on one foot, walk on tiptoe, and jump with both feet. Participation in self-care activities: Increased motor skills allow toddlers to participate in self-care activities. Slide 7: Fine Motor Development Toddler This slide discusses fine motor skill development: Increasingly skillful manual dexterity: Toddlers gain more control over their hands and fingers. Scribbling: They progress from spontaneous scribbling to drawing simple shapes and stick figures. Feeding self: Toddlers begin feeding themselves with a spoon, gradually gaining accuracy. Stacking blocks: The ability to stack blocks improves with age. 18 month-olds stack 3-4 blocks, 24 month-olds stack 6-7 blocks, and 30 month-olds stack 8 or more blocks. Casting/throwing objects: This is a common activity, especially around 15 months. Slide 8: Sensory Changes This slide covers sensory development: Visual acuity: 20/40 vision is acceptable for toddlers. Vision acuity and accommodation: Vision and the ability to focus are still developing. Depth perception: Depth perception is immature. Eye-hand coordination: Eye-hand coordination improves with development. Reaching for objects: Toddlers reach for attractive objects around 15 months. Looking at pictures: Around 12-18 months, toddlers look at pictures and identify forms. Hearing, smell, taste, and touch: These senses develop along with other skills and are used to explore the environment. Slide 9: Cognitive Development This slide introduces cognitive development according to Piaget: Sensorimotor stage transition: Toddlers complete the sensorimotor stage around 24 months, and then move to the preoperational stage. Egocentrism: Toddlers primarily see things from their own point of view. Thinking with images and symbols: Toddlers begin to use symbols to represent objects, people, and places. Causal relationships: Toddlers become aware of the relationships between events. Socialization with significant others: Toddlers socialize with siblings and other significant individuals. Spatial relationships: Toddlers learn about spatial relationships. Object permanence: Toddlers understand that objects continue to exist even when they are not visible. Imitation: Toddlers imitate actions they have seen others perform. Domestic mimicry: Toddlers engage in pretend play, imitating domestic activities. Concept of time: Toddlers begin to develop a very early understanding of time. Slide 10: Language Development: Thoughts into words This slide details language development: 18 months: About 50 words. 24 months: About 200 words. Higher comprehension: Toddlers understand more words than they can use themselves. 2-3 word sentences: Toddlers start combining words to form simple sentences. Learning multiple languages: Toddlers can learn more than one language. Response to tone and expressions: Toddlers respond to the tone of voice and facial expressions. Empathy and Minimizing Frustration: Showing empathy for the toddler trying to communicate minimizes frustration. Moral Development: Toddlers do not understand the concepts of right and wrong and behave to avoid unpleasant experiences and seek pleasant experiences. Slide 11: Psychosocial Development Toddler This slide addresses psychosocial development based on Erikson's stages: Erikson: Sense of autonomy vs. doubt and shame: The main psychosocial conflict during this stage is developing autonomy versus feeling doubt and shame. Developing autonomy: Toddlers are developing a sense of independence. Increasing independence: Toddlers want to do things for themselves, such as dressing, walking, feeding, and toileting. Making choices: Toddlers want to make choices about their environment. Negativism ("no"): Saying \"no\" is a common way for toddlers to assert their independence. Strong will and temper tantrums: Toddlers display strong will and often exhibit temper tantrums when frustrated. Ritualization: Rituals provide toddlers with a sense of comfort. Moves from solitary to parallel play: Toddlers begin to play alongside others, but they don\'t yet actively play with others. Attachment and fear of separation: Toddlers remain strongly attached to their parents and fear separation. Slide 12: Health Risks This slide presents potential health risks for toddlers: Increased mobility, independence and curiosity: Increased mobility and curiosity lead to a higher risk of injury. Childproofing the environment: It is crucial to make the home safe for a toddler to prevent injury and poisoning. Putting objects in mouth: Toddlers are interested in putting objects and substances in their mouths. Lack of understanding of danger of water: This lack of awareness makes drowning a significant risk. Close supervision and setting limits: It is essential for adults to closely supervise toddlers and set safety limits. Complete dependence on parents: Toddlers rely on their parents to keep them safe. Automobile safety: Car seats are essential to ensure safety while traveling. Rear-facing car seats: Rear-facing car seats are recommended for all children under 2 years old. Slide 13: Health Risk cont. This slide highlights some specific safety and prevention strategies: Motor vehicle safety: Always use car seats appropriately and supervise children near traffic. Drowning prevention: Supervise closely near water, fence pools, and keep toilet lids closed. Burn prevention: Keep hot items and appliances out of reach, use guards on heat sources, and check bathwater temperature. Poisoning prevention: Store all potentially toxic agents in a locked cabinet and out of reach. Fall prevention: Secure windows, use gates on stairs, and remove scatter rugs. Choking and suffocation prevention: Avoid giving small, hard foods and use toys that do not have small parts. Bodily harm prevention: Avoid giving sharp or pointed objects to toddlers, especially when they are walking or running. Dangers from people, strangers, and animals: Teach personal safety and supervise interactions with animals. Slide 14: Nutrition This slide addresses nutrition during toddlerhood: Stop breast milk or formula: Toddlers usually stop drinking breast milk or formula. Inadequate iron intake: Excessive milk intake can lead to decreased appetite for solid foods which can result in iron deficiency. Increase solid foods and cow\'s milk: Toddlers need more solid foods and can begin drinking cow's milk. Limit milk intake: Limit milk intake to 500-750 mL (2-3 servings) per day. Whole milk: Children should not drink low-fat or skim milk until 2 years of age; whole milk is needed for physical and intellectual growth. Balance intake: A balanced diet includes grains, vegetables, fruits, proteins, and dairy products. Well-nourished toddler: A well-nourished toddler should have a steady, proportional gain in height and weight. Chopped foods and finger foods: Toddlers prefer chopped or finger foods for self-feeding. Variety of foods: Offer a variety of foods to ensure a balanced diet. Slide 15: Nutrition Cont. This slide continues the discussion on nutrition: Small appetites: Young children can have small appetites, which can make mealtime challenging. Variety of healthy foods: Encourage a variety of healthy food options. Small meals and snacks: Offer small meals and snacks at regular intervals. Child decides how much to eat: Allow children to decide how much they want to eat. Chopped foods and finger foods: Toddlers prefer chopped or finger foods for self-feeding. Variety of foods: Offer a variety of foods. Varying intake: It\'s normal for children to eat more at some meals and less at others. Activity level: A child's activity level can impact their appetite. Growth spurts: Growth spurts may result in more hunger. Emotions: Emotions such as excitement or sadness can affect appetite. Canada\'s Food Guide: Review and use Canada\'s Food Guide for healthy eating recommendations. Slide 16: Take time to review: Canada\'s Food Guide This slide emphasizes the importance of using the Canada\'s Food Guide for nutritional guidance. It also mentions additional resources: Safety in the Home & Community: This information is available for parents with infants and toddlers. CDC website: It mentions the website from the Centre of for Disease Control and Prevention (CDC) for additional information. Ontario Poison Centre: It mentions the Ontario Poison Centre which can provide resources about Household Hazards. Play the Game: Candy or Pill This is a game that can help educate parents and children about potential hazards. Slide 17: Safe toys for toddlers This slide discusses age-appropriate toys: Toys for 1-year-olds: Focus on toys that engage their movement, language, and exploration. This includes board books, recordings with songs and stories, creative materials (markers, crayons, paper), pretend play items, building blocks, and toys that encourage movement. Toys for 2-year-olds: These toys should support problem-solving, pretending, creativity, and physical activity. This includes puzzles, blocks, transportation toys, construction sets, child-sized furniture, dress-up clothes, art supplies, picture books, music players, and toys for large motor skills. Slide 18: Nursing care for the toddler This slide begins the section on nursing care for toddlers, listing some goals: Minimize separation anxiety: Reduce anxiety related to separation from parents. Establish trust: Build a trusting relationship with the child. Reduce fear: Reduce the child\'s fear of medical procedures. Minimize physical discomfort: Ensure the child is as comfortable as possible during procedures. Foster normal growth & development: Support the child\'s growth and development. Incorporate play & diversional activity: Include play in their care. Slide 19: Nursing care for the toddler cont. This slide provides more detailed techniques for nursing care: Get down to their level: Squat or sit to be at the child's eye level. Use a soft voice: Especially use a soft voice if a child is crying; they may quiet down to listen. Make examination a game: Use play to establish a safe, non-threatening environment. Use simple language: Communicate with words they can understand, such as 'boo boo' or 'ouch'. Slide 20: Nursing care for the toddler This slide addresses specific language choices: Avoid threatening words: Avoid using certain words that can be frightening for a toddler. Examples of words to avoid: Avoid words like "shot," "fix," or "take your vital signs". Slide 21: Nursing Care for the Toddler: Think about the growth and development of the toddler This slide is a transition to more practical application of nursing care with a summary of concepts: Learning through exploration and choice: Toddlers learn through exploration and making good choices, and are learning self-control. Slide 22: How do nurses care for the toddler? This slide describes how to incorporate interventions into care: Allow toddler on parent\'s lap: Allow the toddler to sit on the parent's lap during the exam. Give choices: Offer simple choices to give toddlers some control. Avoid asking permission: Refrain from asking the toddler for permission; instead, state calmly what area you will examine next. Use distraction: Use distraction such as having a parent read or blow bubbles to divert attention during a procedure. Prepare no more than one day ahead: Prepare a toddler no more than one day ahead of time for a procedure. Ask child to point: Ask the child to point to a body part you will examine. Slide 23: Nursing care for the toddler cont. This slide continues with practical approaches for nursing care: Show the child the equipment: Show the child the equipment you will use. Praise the child: Praise the child for cooperation and use their first name. Allow self-care: Allow the toddler to dress self, use a potty chair, and self-feed to encourage autonomy. Name objects with explanations: Name objects using simple explanations. Perform treatments in a separate room: Perform treatments in a separate room rather than the child's bedroom. Offer choices after the procedure: Give the toddler a choice after the procedure. Provide a nightlight: Offer a nightlight in the child\'s room. Give choices to decrease resistance: Give the toddler a choice to decrease resistance. Comfort after painful procedure: Comfort the toddler after a painful procedure by rocking, singing, offering a snack, or holding them. By thoroughly exploring each of these slides, we have gained a comprehensive understanding of the developmental changes, health risks, and nursing care strategies relevant to toddlers. Remember, toddlers are experiencing a period of incredible growth and learning, and our role is to support them with understanding, patience, and appropriate guidance. Let me know if you have any other questions or would like me to elaborate on a specific area!