Health promotion of the Toddler.

Erikson: Autonomy vs shame and doubt (Psychosocial)

Time of exerting independence, struggling for self-mastery and learning to do for themselves.

Negativism (psychosocial)

always saying "no" is normal part of development as they begin to express their independene

Ritualism (psychosocial)

Routines provide a sense of comfort/control. Toddlers thrive on a routine that needs to be followed for control.

Typical toddler appearance

Rounded abdomen, slight swayback, and a wide-based stance.

Birth weight changes

Quadrupled by 2-3 years

How many lbs should a toddler be gaining?

4-5 pounds a year.

Until what age should head circumference be routinely measured?

2 years of age

By what age has the head reached 90% of its adult size?

2 years of age

anterior fontanels

clsoed by 18 months

Sphincter control (voluntary control of elimination)

Around 18-24 months sphincter control occurs wait until this milestone for potty training.

Upper respiratory infections

Very common, i.e., otitis media and tonsillitis, for toddlers. Not life-threatening.

Gross motor skills @ 15 months

Walks without help, creeps up stairs

Gross motor skills @ 18 months

Runs clumsily; falls often, throws ball overhead, jumps in place with both feet, pulls and pushes toys.

gross motor skills @ 2 years

Walks up and down stairs by placing both feet on each step

Gross motor skills @ 2.5 years

Jumps across the floor and off a chair or step using both feet, stands on one foot momentarily, and takes a few steps on tiptoes.

Fine motor skills @ 15 months

Uses a cup well, builds a tower of two blocks

Fine motor skills @ 18 months

Manages a spoon without rotation, turns pages in a book, two or three at a time, builds a tower of three or four blocks.

Fine motor skills @ 2 years

Builds a tower of six or seven blocks turns pages of books one at a time.

Fine motor skills @ 2.5 years

Draws circles has good hand-finger coordination.

Cognitive development (piaget sensorimotor) (12-24 months)

Trial and error, object permanence, domestic mimicry, concept of timeout established.

Piaget: preoperational (2-4 years)

Symbolic thought, objects are considered large or small, Language= me, I, Mine.

1 year old language development

One word sentences i.e. mama, doggie, bye-bye

2 year old language development

2-3 word sentences "want milk"

3 year old language development

combining 3 or more words to make simple sentences, "me want milk", approximately 300 words by age 3.`

Toddler language delays

Early identifcation of a child with potential speech delay is critical

Sepration

toddlers see themselves as separate from parents

Indivuation

forming sense of self, learning to explore & explore control of their world

Egocentric

Toddlers can only view things from their POV.

When is autism typically evident?

In the 2nd year of life

When should screening for autism occur?

At the 18 and 24-month well-child visit

What is a reliable tool for autism screening?

M-CHAT

What is a behavior associated with autism related to name response?

Reduced response to name

What is a communication behavior associated with autism?

Abnormal communication

What type of behaviors are repetitive in individuals with autism?

Repetitive behaviors

What is an abnormal visual behavior associated with autism?

Abnormal visual attention

What is a behavior related to emotional regulation in autism?

Atypical emotional regulation

What is a motor control issue associated with autism?

Reduced motor control

When is early intervention for missed milestones important?

at 3 years of age.

What is a normal behavior in body image development?

Exploration of genitals

At what age do children typically begin to observe differences between male and female body parts?

Around 3 years of age

When do children typically develop their gender identity?

By 3 years of age

Parallel play

toddlers usually play alongside another child rather than cooperatively.

Issues related to the toddler

Toilet training, temper tantrums, sibling rivalry

Toilet training a toddler

If resistance is shown child not ready, 24-30 months makes achieving task more successfuly.

When should a child see a dental provider?

By 12 months

What should be avoided to prevent pooling of milk in the mouth?

Bottles and sippy cups

What can pooling of milk in the mouth lead to?

Tooth decay

Car safety

Toddlers over the age of 2 or who exceed height recommended to have a forward-facing car seat, safest in the backseat.

Fire and Burn safety

High risk of burns in the kitchen, pull down hot foods and liquids.

A nurse is caring for a 2-year-old child. During the exam, the parents ask when their toddler should be toilet-trained. How should the nurse respond?

Children need mental readiness and psychological

A mother brings her 15-month-old son to the clinic during assessment, the mother makes the following comments. Which comment merits further investigation?

"My son is not crawling yet"