Chapter_032.pdf

Perry: Maternal Child Nursing Care, 7th Edition Chapter 32: The Toddler and Family Key Points The toddler stage, extending from 12 to 36 months, is a period of intense exploration of the environment. Biologic development during the toddler years is characterized by the acquisition of fine and gross...

Perry: Maternal Child Nursing Care, 7th Edition Chapter 32: The Toddler and Family Key Points The toddler stage, extending from 12 to 36 months, is a period of intense exploration of the environment. Biologic development during the toddler years is characterized by the acquisition of fine and gross motor skills that allows children to master a wide range of activities. Although most of the physiologic systems are mature by the end of toddlerhood, brain cells continue to increase in size and brain growth is 75% completed by the end of two years. Locomotion is the major gross motor skill acquired during toddlerhood, followed by increased fine motor development as demonstrated by increasingly skillful manual dexterity. Specific tasks in the psychosocial development of a toddler include differentiating self from others, tolerating separation from parent, coping with delayed gratification, controlling bodily functions, acquiring socially acceptable behavior, communicating verbally, and interacting with others in a less egocentric manner. According to Erikson, the major developmental task of toddlerhood is acquiring a sense of autonomy while overcoming a sense of doubt and shame. In Piaget’s sensorimotor and preconceptual phases of development, the toddler experiments by incorporating the old learning of secondary circular reactions with new skills and applies this combined knowledge to new situations. There is the beginning of rational judgment and intellectual reasoning, an awareness of causal relationships, and awareness of spatial relationships and an advancement of object permanence. The child’s family and environment strongly influence the child’s perception of the world around him or her, and this often includes spirituality. As in infancy, the development of body image closely parallels cognitive development. A major task of the toddler period is differentiation of self from significant others. The most striking characteristic of language development during early childhood is the increasing level of comprehension. Copyright © 2023, Elsevier, Inc. All Rights Reserved. The solitary play of infancy progresses to parallel play—toddlers play alongside, not with, other children. Parental concerns during the toddler years include the following: toilet training; coping with sibling rivalry and dealing with temper tantrums, negativism, and regression. It is now recognized that lifetime eating habits may be established in early childhood, and health care workers are increasingly emphasizing the role of food selection choices, exercise, stress reduction, and other lifestyle choices on the quality of adult life and survival. Total sleep decreases only slightly during the second year and averages about 11 to 12 hours a day. A consistent nightly bedtime routine is associated with better sleep patterns. Regular dental examinations, fluoride supplementation, removal of plaque, and provision of a low-cariogenic diet promote optimum dental health. A major factor in the critical increase of injuries during early childhood is the unrestricted freedom achieved through locomotion combined with a lack of awareness of danger within the environment. Fatal injuries are primarily a result of motor vehicle accidents, drownings, and burns. Pediatric poison ingestion is common and rarely results in morbidity or mortality. The ultimate objective is to prevent poisonings from occurring or recurring. Children are at high risk for aspiration, suffocation, falls, burns and drowning that require family education in order to prevent these situations. Copyright © 2023, Elsevier, Inc. All Rights Reserved.