U1L3: Toddler & Preschooler Development

when does the anterior fontanel close?

by 12-18 months

when should a toddler reach half an adult height?

by 2 yrs

what should a toddlers be 4x their birth weight?

30 months

sensory changes in toddlers (3)

- visual acuity 20/40

- depth perception still developing

- lack of discrimination for taste (risk for poisoning)

neurological changes in toddlers (2)

- 75% complete brain growth at 2 yrs & 90% at 3 yrs

- myelinization complete at 2 yrs

whats the earliest age a toddler can be potty trained?

2 y/o -> when they develop sphincter control

respiratory changes in toddlers (2)

- tongue, tonsils, and adenoids enlarge

- eustachian tubes shorten and straighten

cardiovascular changes in toddlers (2)

- decrease HR & increase BP

- BV easily compressed when palpated

when is primary dentition complete?

30 months

GI changes in toddlers (3)

- enlarging stomach size

- slowed growth requirements reduce intake

- voluntary control of elimination

GU changes in toddlers (3)

- bladder capacity increases

- control of urethral sphincter

- short urethra

15 month old gross motor abilities

takes few steps alone

15 month old fine motor abilities

feeds self finger foods

18 month old gross motor abilities (3)

- walks independently

- climbs stairs w help

- seats self in chair

18 month old fine motor abilities (4)

- scribbles

- tries to use spoon

- throws a ball

- stacks 3-4 blocks

24 month old gross motor abilities (3)

- runs

- kicks ball

- walks up and down stairs w help

24 month old fine motor abilities (4)

- eats w spoon

- stacks 6-7 blocks

- turns doorknobs & unscrews lids

- points to named pictures & objects

30 month old gross motor abilities

jumps off the ground w both ft

30 month old fine motor abilities (3)

- turns knob

- turns book pages one at a time

- takes off some clothing

36 month old gross motor abilities (3)

- pedals a tricycle

- climbs well & runs easily

- bends over without falling

36 month old fine motor abilities (4)

- uses a fork

- strings items tgt

- puts on some clothes by self

- copies a circle

when do toddlers transition from piaget sensorimotor to preoperational?

around 2 yrs till 7

cognitive development of toddler (5)

- developed object permanence

- have memories that relate to them

- unable to understand viewpoints (egocentric)

- mental representation

- rdg daily

are toddlers better at comprehension or communication?

comprehension -> receptive language

12 month old language milestone

understands "no" & imitates gestures

15 month old language milestone

uses finger to point & follows command w gesture

18 month old language milestone

>3 words other than mama & dada, more 10-15 words, & follows commands without gesture

24 month old language milestone

2 word sentences & echolalia which resolves by age 3

echolalia

repeats everything

30 month old language milestone

50 words

36 month old language milestone

toddler is understood by most ppl outside of family

toddlers body image (3)

- exploration away from caregivers

- begin naming body parts

- unclear body boundaries

toddlers gender identity

aware of their gender & expected set of behaviors

toddler psychosocial development (6)

- autonomy & shame & doubt

- learning socially acceptable behaviors

- individuation/seperation

- beginning to play w others

- transitional/ security objects

- temperament

nursing takeaways for toddler psychosocial development (2)

- give 2 acceptable options instead of open questions

- praise attempt not just the result

when does stranger anxiety peak & resolve?

peaks at 15-18 m/o & resolves around 30 months

common toddler psychosocial behaviors & how to help with them (3)

- ritualism & negativism -> transitional objects

- temper tantrums -> keep safe & ignore

- regression -> normal & should be ignored

sociocultural influences on toddlers (4)

- homelessness & poverty

- family values

- culture

- food customs

homelessness & poverty effects on toddlers

causes food insecurity & can cause missed well-child visits & immunizations

family value effects on toddlers

who makes healthcare decisions & expectations for discipline & independence

food custom effects on toddlers

which foods are offered & when when shapes intake & growth patterns

culture effects on toddlers

beliefs about illness & treatments & language & health literacy needs

moral characteristics of toddlers (2)

- egocentric

- punishment & obedience -> believe good behavior is rewarded & bad is punished

what type of play do toddlers participate in?

parallel play -> fill & empty containers, play w blocks, books, push & pull, large piece puzzles

common concerns for toddlers (7)

- nutrition

- sleep & activity

- dental health

- discipline

- toilet training

- temper tantrums

- injury prevention

when are eating habits determined?

within first 3 yrs of life

how much should toddlers eat?

3 meals & 2 snacks -> smaller portions

- should eat 1 tbsp/age/food

what kind of foods should toddlers eat? (3)

- fruits, veggies, whole grains

- finger foods, different colors & shapes

- easy to chew & swallow, avoid hard round foods

ritualism

when a toddler likes the same foods (food jag), cup, plate

common toddler nutrition problems (2)

- picky eaters

- physiologic anorexia

what is important to do while a toddler is eating?

watch them & should be in high chair -> choking is silent

common sleep problems in toddlers (3)

- bed resistance

- frequent night walking

- nightmares

ways to improve toddler sleep (3)

- encourage bedtime routine

- nightlight

- transitional object

what can nurses do to help toilet train toddlers?

help parents recognize readiness -> notice interest in or motivation & being dry for 2 hrs during the day

why do toddlers have temper tantrums?

its due to an appropriate lack of self control and inability to control their environment

how can you help when toddlers have temper tantrums? (4)

- attempt to regain control

- remain present to keep them safe

- ignore behavior

- provide ways to express frustration

ways to prevent sibling rivalry (3)

- keep routine

- individual time daily

- involve in care of sibling

what are appropriate ways to discipline a toddler? (2)

- positive reinforcement

- time out/extinction -> 2.5-3 y/o & 1 min for each y/o

musculoskeletal changes in preschoolers (3)

- increasing bone length

- lose the pot bellied look -> more slender

- muscles mature & strengthen

how much should a preschooler grow in height?

6.35-7.62 cm/yr

how much should a preschooler gain in weight?

1.8-2.3 kg/yr

gross motor milestones for a 4 y/o (4)

- stands on 1 ft for 5 secs

- throws ball overhead

- kicks ball forward

- catches bounced ball

fine motor milestones for a 4 y/o (4)

- draws person w 2-4 body parts, circles, squares

- copies capital letters

- uses scissors

- shows hand preference

gross motor milestones for a 5 y/o (4)

- hops on 1 foot

- swings & climbs

- stand on 1 ft >10 secs

- may skip, skate, swim, somersault

fine motor milestones for a 5 y/o (5)

- dresses/undresses

- ties shoelaces

- prints letters

- draws person w at least 6 parts

- cares for own toileting needs

preschooler cognitive development (9)

- piaget -> pre-operational stage

- egocentric to social awareness

- magical thinking

- imaginary friends

- symbolic play -> pretend

- animisms

- easily fooled

- irreversibility

- can't tell time

magical thinking

when kids think their actions or thoughts directly affect the outside world

animisms

thinks inanimate objects are alive

irreversibilty

doesn't understand that you want them to do the opposite of what you tell them

when should stuttering stop?

normal until about age 8

language development for a 4 y/o (5)

- 1,500 word vocabulary

- complete sentences of 4 or more words

- endless questions & exaggeration

- knows basic colors

- counts a few numbers

language development for a 5 y/o (5)

- 2,100 word vocabulary

- sentences of 6-8 words

- talks abt past, future, & imaginary events

- states name & address

- counts to 10

language development for a 6 y/o (2)

- mastered sh, l, th, & r

- bilingual children may lag slightly, but can differentiate & use both languages

body image for preschoolers (4)

- recognize different appearance, skin color, racial identity

- vulnerable to learning prejudices & biases

- poorly defines body boundaries

- concerned regarding skin integrity

sexuality for preschoolers (4)

- attachment to opposite sex parent

- identify w same sex parent

- role playing

- sexual exploration w/o realizing what they're doing

what is erikson's initiative v guilt?

around age 3-6 and shows the balance between trying new things and being afraid of failing

what stage of kohlbergs stages of moral development is a preschooler in??

preconventional

moral development of preschooler (4)

- perceive rules as definite

- believe rules are set by others

- learn standard of acceptable behavior -> feels guilty if violated

- may fight, bite, lie

what type of play do preschoolers like to participate in? (4)

- imaginary (3-6 y/o)

- parallel

- associative (3-4 y/o)

- cooperative (4-5 y/o)

what activities of play do preschoolers participate in? (5)

- playing ball

- puzzles

- electronic games

- reading

- hand puppets

what stage should toddlers master in eriksons theory?

autonomy

what stage should preschoolers master in eriksons theory?

initiative

preschooler nutrition (2)

- 5 servings of fruits & vegetables a day

- no sweetened beverages

preschooler sleep & rest (3)

- 10-13 hrs/day including naps

- keep consistent bedtime routine

- nightlight to help w fear of dark

preschooler nightmares

occurs in second half of night & causes child to wake fully -> remembers dream & hard to fall back asleep

prechooler night terrors

occurs shortly after falling asleep & wakes partially but screaming -> doesn't respond to parent & returns to sleep w no memory of it

what 4 conversations should happen with every family regarding injury prevention for preschoolers?

- water safety -> teach how to swim & never unsupervised

- wheels & play > helmet & supervise

- street safety -> no playing near curb or car

- firearms -> locked