Toddler Development Milestones PDF

TODDLER EDWIN DEL ROSARIO, CCRN, ACNP, AGNP TODDLER: GROWTH AND DEVELOPMENT LESSON 1  TODDLER Age from 1-3 yrs. Old Walking, talking child with sense of independence “terrible twos” Favorite word “NO” Ca...

TODDLER EDWIN DEL ROSARIO, CCRN, ACNP, AGNP TODDLER: GROWTH AND DEVELOPMENT LESSON 1  TODDLER Age from 1-3 yrs. Old Walking, talking child with sense of independence “terrible twos” Favorite word “NO” Caregiver task: supports child’s independence by letting the child explore  GROWTH AND DEVELOPMENT Speaks in two-word sentences 20 deciduous teeth present @ 2.5 years Chest circumference > head @ 2 years Heart rate : 90-110 Pouchy abdomen: weak abdominal muscles Baby fats begin to lordosis disappear Wide based gait  ANTHROPOMETRICS Physical Body Weight Height Head Growth contour standard quadrupl gains 5 Chest > Lordosis growth ed his inches (12 Head waddle chart birth cm) /year Anterior with wide measure weight estimated fontanelle stance height with gains only adult child lying closes about 5-6 height: down lbs. (2 kg) doubles @ 2 years  PHYSIOLOGIC CHANGES HR slows down 110 to 90 Cardiovascular BP increases to 99/64 mmHg RR slows down, remains abdominal Respiratory Respiratory tract lumen increases = less respiratory illnesses brains develops to 90% of adult size Nervous system complete myelination of spinal cord  PHYSIOLOGIC CHANGES - stomach capacity increases to the point that the child can eat 3 meals a day GI SYSTEM - stomach secretions become more acid → GI infections are less common - IgG and IgM antibody production becomes mature IMMUNE SYSTEM @ 2 years of age- the passive immunity effects from intrauterine life are no longer operative - 8 new teeth the canines and the first molars erupt during the 2nd year DENTITION - all 20 deciduous teeth are generally present by 2 1/2 to 3 years at age  PSYCHOSEXUAL DEVELOPMENT FREUD’S Anal stage - TOILET training  PSYCHOSOCIAL DEVELOPMENT ERICKSON’S shame and Autonomy doubt VS.  PSYCHOSOCIAL TASK Differentiate Ability to Increase Vocabulary Assert withstand self from independence increases ownership delayed caregiver gratificatio n Less likely to Help with Temper Hoarding Possessiveness fear stranger dressing tantrums  COGNITIVE DEVELOPMENT PIAGET’S Cognitive development Acquisition of Mental Preoperational language symbolism thoughts  LANGUAGE DEVELOPMENT 12 mos. 18 mos. 18 mos. – 2 2 years 24 3 years knows identify Y. follows months remembe own Begins to simple gives r and geometri repeat 3 name c forms use directio first numbers Refer to short ns name gives full self sentenc name es MAGICAL SYMBOLISM Object permanence Transition Magical al objects thinking Ritualistic behavior PREOPERATIONAL THINKING Transductive Global organization Centration Animism Irreversibility Magical thinking Inability to conserve  MORAL DEVELOPMENT KOHLBERG’S Preconventio nal Phase punishment No sense of obedience morality  SPIRITUAL DEVELOPMENT FOWLER’S Spiritual development learn about God Assimilate Vague idea of Routine: saying through behavior related God prayers Caregivers to divinity TODDLER: DEVELOPMENTAL MILESTONES LESSON 2  DEVELOPMENTAL MILESTONES gain about three to five pounds Physical grow three to five inches between ages one and two, Symbolic thought. Cognitive deferred imitation able to recall recent events autonomy vs. independence Emotional Balance with consistently sound rules Terrible two  GRADED INDEPENDENCE/NEGATIVISM Graded independence/negativism Give opportunity to Avoid use of pain, Provide Safe make choices ridicule = punishment environment  DEVELOPMENTAL MILESTONES 15 mos.: interacting with other people Socialization 18 mos. : imitates caregiver 2 years: aware of gender Parallel play Play 18 mos.: enjoys pull toys 2 yrs.: imitate adult action: cooking Favorite word: NO 15-18 mos.: knows 10x more words than they can verbally communicate Language 2 years: 50-100 words. Use 2 or more word in combination 3.5-4 yrs.: uses I, me, her, him 5 yrs.: uses thousands of words, speaks in sentences,  PLAY Parallel play Physical and social development Purpose Therapeutic value educational moral formation free, spontaneous, Characteristics active no rules, constructive Based on preference Selection no sharps objects  AGE FINE MOTOR GROSS MOTOR LANGUANGE PLAY MONTHS 15 Puts small pellets into Walks alone 4-6 words Can stack 2 bottles Can seat self in a blocks Scribbles with chair Enjoys being read pen/crayons Can creep upstairs to Hold spoon well (may still Drops toys for turn it upside down) adult to recover (explore sense of permanence) 18 No longer rotate spoon to Can run and jump 7-20 words, uses Imitates household his mouth in place jargoning chores Walk up/down stairs Names one body Begins PARALLEL (hold on railings) parts play 24 Opens doors by turning Walks upstairs 50 words (two- Parallel play doorknobs alone word sentence) Can unscrew lids (both feet on same (noun, pronoun, level) verb 30 Makes simple lines/strokes Jumps down from Verbal language Spend time playing for crosses with pencil chair increases house, imitate Knows full name parents action  TOYS Car and trucks Balls Building blocks Stuff toys (security objects) Play telephone Paly hammer, drums, pots (outlet of aggression) Push/pull toys Simple puzzles Crayon Special Needs , Health Promotion, and Application of the Nursing Process LESSON 3  PROMOTING SAFETY Cuts/ Falls Burns Poisoning Car safety Drowning stabs Make your all rear-facing Do not house Keep potential car seat unattended Lock guns child- children hazards until 2 near water/bath tub proof away from should be years appliances in locked cabinet Childproof: Keep sharps out swimming pools of reach Lead poisoning  NUTRITION Nutrition Requirement Special needs less appetite sedentary: meals: 3x/day than infant 1000 kcal/d High CHON, weaning from active: 1400 CHO, moderate breastfeeding kcal/d fats Offers finger Adequate foods, allows a Calcium and choice Phos, Iron Prefers to eat same type of food  HYGIENE Dental Dressing Sleep Bathing care Encourage Encourage to Seeping healthy Enjoys bath dress 8hrs./night snacks, not time themselves napping 2x/d, high CHO, sweet foods Need shoes for sleeping 12 drink protection as Not to leave hrs./night, fluorinated soon as they unsupervised napping 1x/d drinks walk can put on their socks and underpants  TOILET TRAINING Bowel training should be started before Principle bladder training Training should not be accomplished s of during illness Consistency toilet Positive maternal attitude Child must feel secure when seated training on toilet bowl No distractions during training TOILET TRAINING : REQUIREMENTS Physiologic Sphincter control Psychologic Understands act of Desire to please the elimination mother Can verbally communicate need to defecate  HEALTH CONCERNS: TODDLER Delayed Child begins to speak by 15 mos. of age speech Ritualic Acceptance Do not interference behavior Allows toddler to complete: prevent anxiety Toddler’s “NO” Intervention Negativism limiting number of questions asked of a child making statement rather than question Allow to choose  SPECIAL NEEDS OF A TODDLER begins at about 7 months, persists throughout Separation preschool Intervention say goodbye firmly, repeat explanation, then anxiety leave Assure that you will return Toddlers are independent enough but do not have Tamper vocabulary to express frustration Intervention Tell the toddler that behavior is unacceptable tantrum Ignore  SPECIAL NEEDS OF A TODDLER slowness in carrying out request Cannot decide which of the two action to take Dawdling Intervention Give specific instruction Allow child to learn by experience Refers to natural jealousy and resentment of a child Sibling Dethronement issue Interventions Discuss pregnancy and coming of a new child Rivalry Role playing: using dolls Use “pet” as a training Do not leave with an infant/newborn  SPECIAL NEEDS OF A TODDLER Retreat from a present pattern of functioning to past level of behavior Causes: stress (hospitalization) Regressio Intervention Ignore it n Praising existing pattern of appropriate behavior No new areas learning during stress  SPECIAL NEEDS OF A TODDLER Separation anxiety Learning to tolerate and Understands object Acknowledge the master brief permanence behavior but do periods of concepts not tolerate separation is a task THANK YOU HAVE FAITH