Toddler GD

1-2 years, 11 months

Age of toddlers

1-2 years

What are the ages of young toddlers?

2 years, 11 months

What are the ages of older toddlers?

Increases steadily in SPURTS

• Gain 3-5 LBS per YEAR

• Birth weight QUADRUPLES (x4) by 2-3 years

How does WEIGHT change in toddlers?

Steadily in SPURTS

• 3 INCHES per YEAR

• Reach half of adult height by 2 years

How does LENGTH/HEIGHT change in toddlers?

Reaches 90% of adult size by 2 years

What does the head circumference of an toddler look like?

• Potbellied appearance

• Short, slightly bowed legs

• All systems maturing (respiratory takes a little longer)

What does the physical appearance of toddlers look like?

Autonomy vs. Shame and doubt (1-2 years, 11 months)

What stage of Erikson’s psychosocial development are toddlers in?

• Achieves autonomy and self-control

• Exerting independence but ambivalent (don’t know danger)

• Withstands delayed gratification

• NEGATIVISM

• EMOTIONAL LABILITY

• PARALLEL PLAY

What does the autonomy vs. shame and doubt stage look like for toddlers?

Negativism

Resistance to external suggestions or commands, say the word “no” all the time

Parallel play

Playing side by side but not with each other

• Sensorimotor (birth to 2 years)

• Preoperational (2-7 years)

What stage of Piaget’s psychosocial development are toddlers in?

• Exploring environment with sense (TRIAL AND ERROR)

• Imitation of tasks

• Curious

• Ability to wait

• Routines (feel safe)

What do toddlers do during the sensorimotor (1 year) stage?

• Egocentrism

• Animism

• Magical thinking

• Symbolic thought

• Immature logic/thinking

Plays make-believe with dolls, animals, and people

What do toddlers do during the preoperational (2-7 year) stage?

Anal stage

What stage of Freud psychosocial development are toddlers in?

• Achieving anal sphincter control (potty training)

• Exploring one’s body (touching)

What do toddlers do during the anal stage?

Premorality or Preconventional

• Stage 0 (birth to 2 years)

• Stage 1 (2-3 years)

What stage of Kohlberg psychosocial development are toddlers in?

• No morals

• Do what they like

• Dislike what hurts them

• Right or wrong determined by PHYSICAL CONSEQUENCE

What do toddlers do during the premorality or preconventional stage?

Toddler gait, walks independently

What happens at 12-15 MONTHS during the development of a toddler’s GROSS motor skills?

• CLIMBS STAIRS WITH ASSISTANCE

• Throws a ball

What happens at 18 MONTHS during the development of a toddler’s GROSS motor skills?

• Runs, kicks ball, jumps

• CLIMBS STAIRS WITH NON-ALTERNATING FEET HOLDING RAILING

What happens at 24 MONTHS during the development of a toddler’s GROSS motor skills?

Holds cup with two hands

What happens at 12-15 MONTHS during the development of a toddler’s FINE motor skills?

• Turns book pages

• Removes clothing

• Draws with vertical and circular strokes

What happens at 18 MONTHS during the development of a toddler’s FINE motor skills?

• Turns doorknob

• Builds tower of 4-6 cubes (stack)

What happens at 24 MONTHS during the development of a toddler’s FINE motor skills?

• Sensorimotor (Piaget)

• Preoperational (Piaget)

• Routines (do not understand time)

• Vision 20/50 at 15-18 MONTHS

What are the cognitive and sensory developements of a toddler?

• Erikson (Autonomy vs. Shame and Doubt)

  • NEGATIVISM

  • TEMPER TANTRUMS

  • PARALLEL PLAY

• Aggressive and impulsive behaviors

• Separation anxiety

• REGRESSION

• Safety and security

  • RITUALISM

  • Routines

  • Security item (transition objects)

What are the psychosocial developments of toddlers?

• RECEPTIVE LANGUAGE (listening and understanding) > EXPRESSIVE LANGUAGE (speaking and communicating)

• ECHOLALIA

• TELEGRAPHIC SPEECH (only essential words)

• Predominant words (me, I, mine)

• Bilingual mixing language learning

• Speech delays (early intervention)

• Reading helps!

What is communication and language development of toddlers?

Echolalia

Repetition of words or phrases without understanding

Vocabulary of 50-300 WORDS

• 2 WORD SENTENCES

How many words does a toddler know by 2 years old?

• Immunizations

• Assessment of growth

• Assessment of development

• Prevention of disease

• Acnticipatory guidance

What are the nursing interventions to help the promotion of healthy growth and development of an infant or toddler?

11-14 hours

How many hours do toddlers at 24 MONTHS sleep for?

• Sleep through the night with 1 daytime nap

• Move to a bed

• Bedtime routine

• Night wakening

What does rest and sleep look like for toddlers?

• PHYSIOLOGIC ANEMIA

  • PICKY EATERS/FOOD JAGS

• Promote self-feeding

What are the eating habits of a toddler?

Physiologic anemia

Requires less caloric intake for size compared to infants (not growing as much)

Food jags

A period where a child will eat one specific food almost exclusively for days or weeks

• WEANING from breast milk or formula (switching to whole milk)

• Adequate calcium intake

• No restriction in fat or cholesterol intake younger than 2 years

• Encourage drinking of water and limiting juice intake

• Solid meals

What are the nutritional needs of a toddler?

16-24 OZ OF WHOLE MILK/DAY

How much milk should a toddler get each day?

Iron-deficiency anemia (a lot of milk or eating less)

What is the risks in nutrition for toddlers?

3 full meals and 2 snacks

• Serving sizes: ¼ of adult

• Avoid choking (cut into bite sized pieces)

What do solid meals look like for toddlers?

Dentist by 1 YEAR of age

• Soft toothbrush with pea-sized amount of fluouride toothpaste at 3 YEARS

• By 30 MONTHS, full set of primary (baby) teeth

What does dental hygiene look like for toddler?

60 minutes

How much time of unstructured play should a child have?

• Need discipline to feel secure

• Need limits to learn how to behave

• RISK FOR INJURY (negativism, intense emotions, curiosity)

• Helps promote AUTONOMY

• Have strategies

• Physical punishment can result in a child showing aggression toward others

What does discipline look like for toddlers?

• Setting clear limits

• Allowing natural/logical consequences

• Positive reinforcement

• Diversion/distraction

• Timeout (1 min = years old)

• Needs to be consistent

What are the strategies of discipline?

• Toilet training

• Negativism

• Temper tantrums

• Thumb sucking and pacifiers

• Sibling rivalry

• Regression

What are the developmental concerns for toddlers?

• Increasing time between dry diapers

• Curiosity about adults using the bathroom

• Can remove clothes to sit on the potty chair

What are signs a toddler is ready for toilet training related to urination?

• Bowel movements on a regular schedule

• Squats or grabs diaper

• Crosses legs and/or grunts

• Hides while having a bowel movement

“I didn’t poo, I peed!”

What are signs a toddler is ready for toilet training related to stooling?

• Appropriate size and style of the car seat for child’s weight and age per state law

• Rear facing until highest weight or height allowed by manufacturer

How do you promote safety in the car for the toddlers?

• Fire and burn safety

• Childproof the house

• Preventing falls

• No smoking in home

How do you promote safety in the home for the toddlers?

• Never leave toddler unsupervised

• Childproof the house

How do you prevent injury for the toddlers?

• Ensure all meds, cleaning products, etc. are out of reach of child

• Poison control center

How do you prevent posioning for toddlers?

• Prevent drowning (leading cause of unintentional injury and death in US children)

• Supervision at all times

How do you promote safety in the water for the toddlers?