Toddler hood

Coping with concerns related to normal G&D

1. Toilet training• Anticipatory guidance for families about toilet

training should begin prior to the child's developmental readiness to toilet train.

• Psycho physiologic factors are required for readiness

• There is not a universal right age to begin toilet training or an absolute deadline to complete training.

• Nighttime bladder control normally takes several months to years after daytime training begins (sleep cycle needs to mature.

Toilet training

• Children who do not have nighttime dryness by the age of 6years are requiring intervention

• Bowel training is usually accomplished before bladder training R/to greater regularity and predictability

• The techniques which can be helpful when initiating training:

- Selection of a potty chair or use the toilet, or a portable seat attached to the regular toilet.

- Practice sessions should be limited to 5 or 10 minutes.

Toilet training

- A parent should stay with the child.- Frequent reminders and trips to the toilet are

necessary for children who engrossed in play activities.

- As the child masters each step of toileting (discussion, undressing, going, wiping, dressing , flushing, and hand-washing) he or she gains a sense of accomplishment that should be reinforced by parents.

- Day care providers also play a role in the support and education of parents regarding toilet training practices

Assessing toilet training readiness

• Physical readiness- Voluntary control of the anal and urethral

sphincters is achieved sometime after the child is walking (between 18 and 24 months).

- Ability to stay dry for 2 hours; decreased number of wet diapers; waking dry from nap.

- Regular bowel movements.- Gross motor skills of sitting, walking are

developed- Fine motor skills to remove clothing.

Assessing toilet training readiness

• Mental readiness:- Recognizing urge to defecate or urinate.- Verbal or nonverbal communicative skills to

indicate when wet or has urge to defecate or urinate.

- Cognitive skills to imitate appropriate behavior and follow directions

Assessing toilet training readiness

• Psychologic readiness:- Expresses willingness to please parent.- Able to sit on toilet for 5 to 10 minutes without

fussing or getting off.- Interest about adult's or older sibling's toilet

habits.- Impatience with soiled or wet diapers; desire to

be changed immediately.

Assessing toilet training readiness

• Parental readiness:

- Recognizes child's level of readiness.

- Willing to invest the time required for toilet training.

- Absence of family stress or change , such as a divorce, moving , new sibling, or imminent vacation.

2. Sibling rivalry

• Sibling rivalry: is the natural jealousy and resentment of children toward a new child in the family, when a parent turns his or her attention from the toddler and interact with a new baby.

• Preparation of children for the birth of a sibling is quit individual, but age dictates some important consideration:

1. A good time to start talking about the baby is when toddlers become aware of the pregnancy

2. Telling them that a new playmate will come home soon sets up unrealistic expectations.

Preparation of children for the birth of a sibling

3. Parents should emphasize which routines will stay the same, such as reading-stories.

4. Providing a doll on which toddlers can imitate parental behaviors.

5. A new sibling in the home is stressful, so any additional stresses for the toddler should be avoided or minimized.

6. Pregnancy is an abstraction for toddler, so seeing simple pictures of the uterus and fetus and feeling the fetus move help the child feel involved the experience.

7. Parents can alerting visitors to the toddler's needs, having small presents on hand for the toddler, and including the child in the visit as much as possible.

8.The toddler can also help with the care of the newborn by getting diapers and doing other small tasks.

How children exhibit jealousy

• Some will overtly hit the infant.• Push the child off the mother's lap.• Pull the bottle or breast from the infant's mouth.• Subtle and covert the baby.• Toddlers may verbally express a wish that the infant “go

back inside mommy”.• They will revert to more infantile forms of behavior as

demanding a bottle, using baby talk.• Aggressively acting out toward others.For this reason, infant must be protected by parental

supervision of the interaction between the siblings.

3. Temper Tantrum

• Toddlers may assert their independence by violently objecting to discipline. eg:

- They may lie down on the floor.

- Kick their feet.

- Scream at the top of their lungs.

- Some have learned the effectiveness of holding their breath until the parent relents.

3. TemperTantrum

• The best approach toward tapering temper tantrums requires consistency and developmentally appropriate expectations and rewards.

• Parents can reinforce consistency and expectations by stating :after this story it is bed time”.

• Starting at 18 months, time-outs work well for managing temper tantrums.

• During period of no tantrums practice developmentally appropriate positive reinforcement.

4. Negativism

• One of the more difficult aspect of rearing children in this age-group is their persistent “no” response to every request. Which Is necessary assertion of self-control

• Negativism begins to subside as most children prepare to enter kindergarten.

• One method of dealing with the negativism is to reduce the opportunities for a “no” answer.

• In their attempt to exert control, children like to make choices.

• If their response is negative , parents should make the choice for the child.

5. Regression

• Regression: is the retreat from one's present pattern of functioning to past levels of behavior .

• It usually occurs in instances of discomfort or stress .

• Regression is common in toddlers.• Forms of regression :Any threat to their

autonomy, such as illness, hospitalization, separation, adjustment to a sibling, represents a need up revert to earlier forms of behavior, such as increased dependency, refusal to use the potty chair. temper tantrum and loss of newly learned motor, language, social, and cognitive skills.

5. Regression

• When regression does occur, the best approach is to ignore it while praising existing patterns of appropriate behavior.

• Regression is a child's way of saying," I can't cope with this present stress and perfect this skill as well, but I will if given patience and understanding.”

• For this reason it is advisable not to attempt new areas of learning when an additional crisis is present or expected such as beginning toilet training shortly before a sibling is born.