Toddler 2015

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THE TODDLER(1-3 years old)

Ma.Elizabeth N. Jurado

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BIOLOGIC AND PHYSICALDEVELOPMENT

Weight, Height and Head

Circumference

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Ave. wt gain- 1.8 to 2.7

kg (4-6 lbs)/ yr; 4xthe BW by 2 ½ yearsold

Ave. ht increase- 86.6cm (34 in); 7.5 cm or

3 inches per year;occurs mainly in theelongation of the legs

than the trunk

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Adult height is about twice the

2 year old child’s height Subcutaneous tissues or baby

fat begins to disappear Decreased appetite

Chest circumference exceedsthe head and abdominal

measurements

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Body Contour

“pot- bellied” appearance slightly bowed and curved

legs lordotic- forward curve

of the spine at thesacral area

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Maturation of Body Systems

internal structures of theear and the throat areshort and straight

RR slows but mainly

abdominal HR slows from 110 to 90;BP increases to 99/64

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Brain develops to about90% of its adult size

More developed GIfunctions; has voluntarycontrol of elimination

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By 14-18 mos of age,

the child can retainurine up to 2 hrs orlonger

18-24 mos (completemyelination of the

spinal cord), canretain urine up to 2hours or longer

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phagocytosis more efficient IgG and IgM antibody

production becomes mature;passive immunity effectsfrom intrauterine life areno longer operative

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Teeth

Eight new teeth eruptAll 20 deciduous teethare generally presentby 2 ½ to 3 years

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Sensory Changes

20/40 visual acuity full binocular vision sense of hearing, taste,

smell and touch increasingly

well-developed development of specifictaste preferences

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FINE MOTOR DEVELOPMENT Age Movement

15 months Puts small pellets in smallbottles; scribbles; holds a spoonbut may still turn it upside downon the way to the mouth

24 months Can open doors by turningdoorknobs

30 months Makes simple lines or strokesfor crosses with a pencil

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GROSS MOTOR DEVELOPMENT Age

Movement15 months Walks alone well; can seat well on

chair; can creep upstairs

18 months Can run and jump in place; canwalk up and down the stairsholding on to someone placing bothfeet on one step before advancing

24 months Walks upstairs alone using bothfeet on same step at the sametime

30 months Can jump down from stairs

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PSYCHOSOCIAL DEVELOPMENT

described by Erickson as the stage ofautonomy vs shame and doubt

pride in new accomplishments wants to be independent children should be allowed to do their

part not all things are to be done for them

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PSYCHOSEXUAL DEVELOPMENT

Described as the anal phase

by Freud Aware of gender differences

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COGNITIVE DEVELOPMENT 15 months to 2 years

- sensorimotor phase- “little scientists”- able to remember an action

then imitate it later 2-3 years old

- preoperational thought- deal constructively with symbols- ready for toilet training

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MORAL DEVELOPMENT

parents must not equate the childas being “good” or “bad” if he

can or cannot do a task such aswalking, voiding or defecating inthe proper place

material or emotional bribes rarelyeffective punishment-obedience principle

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SPIRITUAL DEVELOPMENT

intuitive-projective faith faith and religion is learned

from significant othersin the environment development of conscience behaves correctly to avoid

punishment

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LANGUAGE DEVELOPMENT Greatly affected by the

environment Requires intact physiologic

structures and function,intelligence, need tocommunicate and stimulation

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At the age of 2, vocabulary

increases from 300 to 2100words at the end of 5years old

Gives and follows simple commands

Nouns; verbs; adjectives;adverbs; pronouns; genderwords

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To master language:

- practice talking- don’t baby talk-

expose to conversation- read often-

answer questionsbriefly and in simpleterms

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PLAY DEVELOPMENT

Parallel play Toys that require action Parents should not correct

children about the way a

toy is being used as longas it appears to givesatisfaction

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SPECIAL NEEDS OFTHE TODDLER AND

THE APPROACHES TOMEET THESE NEEDS

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LOVE AND SECURITY

Enables the toddler togrow up and reach outfor more mature roles

The mother is still the oneto turn to for physicalcare

The father is hardly known

till toddler stage

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Security or Transitional Object

- an object which has unusualimportance and whichseems to provide securityfor the child (e.g. pillows,blankets,dolls)

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GRADED INDEPENDENCE

Learned gradually and given onlyif he can guard himself fromtrauma A very painful experience mightmake a child afraid to try outnew skills

Develops a sense of self-relianceand adequacy of autonomy

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Learns that there are many

things he would like to do,but cannot or may not

An adult should never use shameor ridicule as a means ofpunishment or ofprevention of forbiddenactivities

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AREAS WHERE GUIDANCE ARENEEDED:

1. elimination control

2. learning language

3. learning social norms

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LEARNING SOCIAL NORMS

- “standard”-

learn simple and basicmovements in washing andbathing self

-

must understand discipline

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DISCIPLINE

Qualities of A ConstructiveDiscipline

1.consistency2.clarity3.firmness4.immediacy5.encouragement of independence

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overdemanding and “laissez -faire” parents fail indisciplining their children

Punishment-results frombreakdown in discipline Taking time-out – 1 minutefor each year up to 5minutes-over 5 years:maximum of 5 minutes

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CONTROL OF BODILYFUNCTIONS

Requirements For Toilet TrainingPhysical maturity

-

control of rectal and urethralsphincter with completemyelination of spinal cord

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Psychological readinessa. recognition of the urge to

hold on and let go; ability tocommunicate this to themother

b. desire to please the mother(by holding on) rather thanto please oneself (by lettinggo) anytime

c. developmental abilities (e.g.to sit,walk)

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Principles of Toilet Training

1. Bowel training should bestarted first beforebladder training

2. Toilet training should notbe started earlierthan 18 months

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3. Bladder training shouldbe started 1 month ormore after bowel

a. day bladder training-established at 2 years

b. night bladder- at 3 years

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4.Training should not bestarted when thechild is ill.

5.Mother’s attitude

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Steps in Toilet Training

1. Observe child’s usual time fordefecation.

2. Use of training pants that canbe pulled down readily

3. Use of comfortable child’stoilet seat/ potty chair

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4.Do not give toys or food thatmay distract him

5.Practice session should belimited to 5-10 minutes

6.Do not flush toilet while childis sitting on it

7. Praise child if he urinates ordefecates

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FECAL SMEARING- 15- 18 months- considers warm feces as gifts- parents should not express

strong disapproval

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PROBLEM AREASOF

A TODDLER

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NEGATIVISM- 18 – 30 months- attempt to assert oneself

as an individual-

a loud “NO” automaticallyeven if they mean yes

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Mgmt:- should not use opposition

to overcome opposition-

don’t ask questions thatwill require a yes or noanswer

-

participate (physical help)- recognize signs of

independence

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RITUALISTIC BEHAVIOR

-

makes rituals of simple task

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TEMPER TANTRUMS-

violent outburst of behavior- best managed byignoring the behavior

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Mgmt:

- remove cause- be calm and patient- protect from harm/

injury; no extraattention

- avoid restraining

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DAWDLING- slowness in carrying a task

Causes:- task may be difficult- to avoid trying a task he knows

he cannot do- confusion

Mgmt:- specific instructions- help child perform task

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SEPARATION ANXIETY- attachment to mother

is possessive andselfish

- greatest fear: abandonment

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Mgmt:-

give transitional object- practice makes perfect

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BASIC NEEDS

OFA TODDLER

1 Bathing

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1.Bathing2.Clothing3.Sleep and Exercise

- 12 to 14 hours of sleepincluding daytime napof 1-2 hours

- with set of bedtime

rituals4.Care of the teeth – 2 ½years: social visit

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5. Nutritional needs-

decrease rate of growthwill decrease caloricrequirement, CHON

and fluid intake- manifested by decreaseappetite known as

physiologic anorexia- 100 kcal/BW- eating time=happy time

P i f f di

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Points for feeding Serve food in small portion

Needs 3 well balanced dietwith snacks

Chop or cut food in smallpieces

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6. Health Supervision- immunization- dental care-

establish good habits7. Accident Prevention

– childproof the house

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Toddler 2015

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