Peds Growth and Development

infant age range

0-12 months

toddler age range

12-36 months (1-3 years)

preschool age range

3-6 years

school age, age range

6-12 years

adolescent age range

12-18 years

freud identifies that personality has what 3 parts?

id (impulses)

ego (mediates)

superego (morality)

freud's theory of psychosexual development includes which 5 stages? what age group goes with each stage?

1) oral - infants (feeding/soothing)

2) anal - toddlers (potty training/independence)

3) phallic - preschool (roles)

4) latency - school age (same-sex peers/no interest in sexual)

5) genital - adolescents (hormones/puberty/who they're attracted to)

erikson's theory of psychosocial development includes what 5 stages? what age group goes with each stage?

1) trust vs. mistrust - infants (rely on caregivers/needs met)

2) autonomy vs. shame & doubt - toddler (establish independence)

3) initiative vs. guilt - preschool (imagination/false associations)

4) industry vs. inferiority - school age (school/rules/failure in school leads to feelings of inferiority)

5) identity vs. role confusion - adolescents (body-image/who am I?/where do I belong?)

piaget's theory of cognitive development includes what 4 stages? what age group goes with each stage?

1) sensorimotor - infants & toddlers (learning through senses & movement)

2) preoperational - preschool (imagination/"shallow"/egocentric)

3) concrete operational - school age (concept of conservation/"easy to trick")

4) formal operational - adolescents (easier to explain/understand without having to see)

kohlberg's theory of moral development includes what 3 stages? what age group goes with each stage?

1) pre-conventional - preschoolers (get rewards/avoid punishment)

2) conventional - school age (rule follower)

3) post-conventional - adolescents (more dilemmas, sacrifices)

____ is more quantitative/measurable, while ____ is qualitative

growth = quantitative

development = qualitative

what is a cephalocaudal pattern of growth?

the sequence in which growth starts the head and moves down the body "head-to-toe" (ex: infants gain control of head first)

what is a proximodistal pattern of growth?

the sequence in which growth starts at the center of the body and moves toward the extremities "near-to-far" (ex: infants gain control of whole hand before fingers)

infants grow at a ____ rate, they have a ____ head, as well as ____ reflexes

rapid; large; inborn

what are inborn reflexes?

reflexes that infants are born with that serve as protective mechanisms; disappear over the first year of the infant's life

examples of inborn reflexes (8)

-rooting

-sucking

-moro (startle)

-stepping

-tonic neck (fencer)

-palmar grasp

-plantar grasp

-babinski

what type of play do infants engage in?

solitary play

what social/emotional development milestones do infants reach at 1 month of age?

-looks at parent

-calms down when picked up or spoken to

what social/emotional development milestones do infants reach at 2 months of age?

-has social smile

-has sounds that differentiate between happy & upset

what social/emotional development milestones do infants reach at 4 months of age?

-laughs out loud

-copies some facial expressions

what social/emotional development milestones do infants reach at 6 months of age?

-looks at self in mirror

-knows familiar faces

-notices strangers

what social/emotional development milestones do infants reach at 9 months of age?

-plays games such a "peek-a-boo" and "pat-a-cake"

-has a favorite toy

-waves bye-bye

-may be afraid of strangers

what social/emotional development milestones do infants reach at 12 months of age?

-imitates parents & caregivers

-cries when parents leave

-can put arms up to help with dressing

what age in infancy does separation & stranger anxiety typically begin?

6 months

infants tend to sleep ____-____ hours/day and then it lessens with age

16-20

what is the safest position for an infant to sleep?

flat on back

when is an infant at the highest risk for dying due to SIDS?

8 wks-6 months

what are some preventative measures for SIDS and suffocation?

-no bumper pads

-no stuffed animals

-no blankets in bed

-ceiling fan on

-no co-sleeping

-encourage breastfeeding (trumps co-sleeping)

infants communicate through ____ and have different ____ based on needs

crying; pitches

babies begin cooing at what age? and begin babbling and making constant sounds at what age?

cooing = 2 months

babbling & constant sounds = 6 months

babies begin copying sounds, saying "mama" and "dada" nonspecifically, and can understand "no" at what age?

9 months

babies begin saying "mama" and "dada" specifically, saying a few words, following simple directions, and understanding simple gestures at what age?

12 months

what should an infants nutrition be for the first 6 months of life?

exclusively breast milk (BM) or formula

what are the benefits of an infant drinking exclusive breast/human milk?

maternal antibodies & it's easily digestible

what supplement is important to give to both mother & infant if they are exclusively breastfeeding?

vitamin D

what can over-diluted formula cause?

electrolyte imbalances

what type of water should formula be mixed with? why?

"nursery" or bottled water; to decrease chance of lead poisoning

what two types of formula are good for infants with formula intolerance?

-alimentum

-nutramegen

what should be introduced into an infants diet first after BM/formula? what age?

iron fortified rice cereal; 4-6 months, can be earlier if GE reflux

why is it important to not over-do it with rice cereal?

it has empty calories, with not a lot of vitamins/nutrients & it can cause weight issues (but helpful if underweight)

what infant reaction indications they are not ready to begin solids/baby food?

tongue thrust

why should infants not consume cow's milk until after 12 months?

it contains a protein (casein) that can cause GI irritation & bleeding

when beginning cow's milk after 12 months of age, what type of milk should they drink at least until 2 years of age? why?

whole milk; it has the correct fat content for brain development

when introducing solid foods how often should it be? why?

every 3-5 days to allow for identification of allergy and GI distress

when introducing solid foods to infants should you start with fruits or veggies? why?

veggies first because of the sweetness of fruit (if you do fruits first they are more likely to turn down veggies)

nuts & shellfish should be avoided until what age? why?

2 years old; allergy risks

what vitamin enhances iron absorption?

vitamin C

what age should crackers & junior foods be introduced?

8-9 months

when should an child be weaned from bottle to cup?

12-15 months (when introducing cow's milk)

why shouldn't children under 2 be given honey?

botulism risk (it's not pasteurized)

what gross motor skills can a 1 month old do?

-moves arms & legs together

-holds chin up when lying on stomach

what gross motor skills can a 2 month old do?

-lifts head & chest when lying on stomach

-keeps head steady in sitting position

what gross motor skills can a 4 month old do?

-supports self on elbow & wrists when lying on stomach

-rolls from stomach to back

what gross motor skills can a 6 month old do?

-rolls from back to stomach

-sits in tripod position

-sits briefly without support

what gross motor skills can a 9 month old do?

-sits well without support

-pulls to stand

-able to go from a lying to sitting position

-crawls on hands & knees

what gross motor skills can a 12 month old do?

-stands independently

-may take first steps

what fine motor skills can a 1 month old do?

-open fingers slightly at rest

what fine motor skills can a 2 month old do?

-brings hands together

-opens & closes hands

what fine motor skills can a 4 month old do?

-keeps hands relaxed

-grasps objects

-brings hands to mouth

what fine motor skills can a 6 month old do?

-transfers objects from one hand to another

-uses raking grasp

-bangs objects on surfaces

what fine motor skills can a 9 month old do?

-feeds self

-picks up small objects with 3 fingers & thumbs

-lets go of objects purposefully

-bangs objects together

what fine motor skills can a 12 month old do?

-uses forefinger & thumbs to pick up small objects

-feeds self with a cup & spoon

-holds crayon with whole hand

best toys for younger infants

those that can be kicked or batted, unbreakable mirrors, and toys with contrasting patterns

best toys for older infants

those that make noise or light up, soft dolls, teething toys, board books, and large blocks

what is the nurse's responsibility in preventing injury & ensuring safety in children of all ages?

education & anticipatory guidance

when should you educate caregivers to begin baby proofing the home?

before the child becomes mobile (this is an example of anticipatory guidance)

how can falls be prevented in an infant?

don't leave on high surfaces alone, make sure they're buckled into seats and swings, use safety gates at top and bottom of stairs

foods with high choking risks (especially for infants/toddlers)

-carrots

-popcorn

-hard candy

-grapes

-marshmallows

-hot dogs

a child should remain in a rear-facing car seat until what age?

2 years old; really until they outgrow height/weight requirements

toddlers growth & physical appearance

-slows (compared to infants)

-adult is twice 2-year-old height

-head circumference increases from 12-24 months

what gross motor skills can a 15 month old do?

-squats to pick up objects

-crawls up steps

-drinks from a cup

what gross motor skills can a 18 month old do?

-walks independently

-pushes & pulls toys when walking

what gross motor skills can a 24 month old do?

-runs

-kicks a ball

-jumps with two feet

-climbs on furniture

what gross motor skills can a 36 month old do?

-pedals a tricycle

-jumps forward

-walks up and down stairs with one foot on each step

what fine motor skills can a 15 month old do?

-marks with a crayon

-puts objects in and out of cups

what fine motor skills can a 18 month old do?

-scribbles spontaneously

-rolls a ball

-eats with a spoon

-helps undress self

what fine motor skills can a 24 month old do?

-copies straight lines and circles

-stacks objects

-turns pages

-throws a ball overhand

what fine motor skills can a 36 month old do?

-turns a door handle

-screws lids on and off

-copies a circle

-builds a tower of six or more blocks

-undresses self

toddlers understand actions can hurt others at ____ years of age & they also ____ the behaviors of others

3; imitate

toddlers are egocentric, meaning what?

believe world revolves around them & are only focused on themselves

you should encourage caregivers to offer ____ to toddlers in order to foster ____

choices; independence

risk factors for emotional and behavioral problems in toddlers

-poverty

-maternal depression

-exposure to toxic substances

what social/emotional development milestones do toddlers reach at 15 month of age?

-hugs parents

-points to things her or she wants

-may have a security object

what social/emotional development milestones do toddlers reach at 18 month of age?

-looks at an adult if something new happens

-may have temper tantrums

-begins to indicate when diapers are wet or soiled

-plays simple pretend games

what social/emotional development milestones do toddlers reach at 24 month of age?

-imitates others

-likes to be with other children

-shows defiance

-shows more independence

-likes to talk about what is happening

what social/emotional development milestones do toddlers reach at 36 month of age?

-eats independently

-begins to share

-separates easily from parents

-shows affection & concern

in toddlers, ____ language develops quicker than ____ language; therefore they are able to understand ____ before giving them

receptive; expressive; directions

toddlers often experience echolalia, what is this?

repetition of words and phrases without understanding meaning

toddlers often speak using ____ speech and only two- to three-word sentences, using only enough words to get the point across

telegraphic ("me do it")

you should encourage caregivers to ____ to their toddlers

read

what language development milestones do toddlers reach at age 15 months?

-follows simple commands

-names a familiar object

-uses jargon (ex: belly vs tummy)

what language development milestones do toddlers reach at age 18 months?

-says single words

-shakes head no

-names two body parts

-names five objects

what language development milestones do toddlers reach at age 24 months?

-uses two-word sentences

-follows simple directions

-names five body parts

-points to pictures when named

-has a vocabulary of around 50 words

what language development milestones do toddlers reach at age 36 months?

-uses three-word sentences

-repeats a story from a book

-understands prepositions such a "over", "under", and "in"

-strangers can understand 75% of the child's speech

-says name & age

-uses plurals

toddlers engage in ____ play & have ____ attention spans

parallel; short

do toddlers understand the concept of sharing?

no

what types of toys are appropriate for toddlers to help develop their gross motor, fine motor, and social skills?

-push or pull toys

-tunnels

-stack-able blocks

-puzzles with large pieces

-larger crayons or chalk

-household objects that can be used to make nouse

-musical instruments

toddler temper tantrums are result of what?

receptive language development versus expressive language development

what are 2 things that can increase temper tantrums?

disruption in routine & inconsistent expectations

how should temper tantrums be addressed?

make sure they are safe & then ignore them; opposite to this, good behavior should be rewarded