Toddlerhood Notes

Toddlerhood (1-3 years old)

• Toddlerhood is generally a happy period.
• Characterized by a slow and steady growth rate.
• A key developmental task is developing independence or autonomy.

Physical Characteristics

• Growth Rate:
  • Height increases by approximately 3 inches per year.
  • Weight increases by approximately 4-6 pounds per year.
  • Extremities grow faster compared to the trunk.
• Dentition:
  • By the age of 2.5 years, most toddlers have 20 primary teeth.

Eyes and Ears

• Otitis Media:
  • Toddlers are prone to ear infections due to the shorter, wider Eustachian tube.
• Visual Issues:
  • Amblyopia (lazy eye) can cause double vision.
  • Strabismus (crossed eyes) is another potential issue.

Motor Development

• Gross Motor Skills:
  • Development relies on the growth and maturation of muscles, bones, and nerves.
  • Examples include walking, skipping, running, and hopping.
• Fine Motor Skills:
  • Examples include self-feeding, dressing, and playing.

Psychosocial Development

• Toddlers are mastering daily activities.
• Encourage safe independence with supervision and guidance.
• Autonomy vs. Independence:
  • Consistency is crucial in reinforcing limitations.
  • Toddlers learn within safe limits.
  • Establishing a safe space is important.
• Discipline: Teaching acceptable behavior within set boundaries.

Psychosocial Concerns

• Separation Anxiety:
  • Toddlers may rely on comfort items (e.g., a blanket) to reduce anxiety.
  • Significant life changes can trigger stress and increase reliance on comfort items. Examples include:
    • New sibling.
    • A move.
    • Starting daycare.
• Sibling Rivalry:
  • Can manifest as feelings of jealousy and insecurity.
  • May lead to angry outbursts or regressive behavior.

Cognitive Development

• Toddlers learn through trial and error.
• Engage in preoperational thought.
• Continue to develop object permanence.
• Exhibit an egocentric view of the world.
• Time is not well understood; it's interpreted by events within their own frame of reference.

Moral Development

• Toddlers imitate parent behavior and teachings.
• Begin to understand right and wrong.
• Learn socially acceptable behaviors.
• Development of self-esteem and positivity are crucial.

Communication

• Language development is automatic and spontaneous.
• Relies on symbolic function and memory.
• Encouraging speech and reading helps build language skills.
• Toddlers can learn more than one language simultaneously.

Nutrition

• Need to establish good eating patterns early, as these habits tend to be lifelong.
• Parents should model good eating practices.
• Offer healthy food options.
• Avoid or sparingly give candy and sugar-concentrated foods.
• Offer hand-held foods.
• Ritualistic food preferences are common.

Sleep and Rest

• Toddlers may resist sleep because they want to play and be involved.
• Short naps during the day are beneficial.
• Bedtime rituals reduce anxiety and provide a sense of security.
• Sleep disturbances are not unusual.

Play

• Toddlers explore and understand the world through play.
• Play supports ego development, cognition, and socialization.
• Symbolic Play:
  • Emergence of make-believe or pretense behaviors;
  • Playing with an imaginary friend.
• Parallel Play:
  • Playing alongside other children but not actively interacting with them.
• Electronic Devices:
  • Provide very little sensory stimulation.
  • Overuse can lead to language delays (supported by research findings).

Child Abuse

• Forms of Child Abuse: Physical abuse, neglect, psychological abuse, sexual abuse.
• All healthcare workers are mandated reporters, responsible for assessing and reporting suspected abuse or maltreatment.
• Primary care providers are in a key position to identify abuse or neglect during well-child and other visits.
• Legal Requirement: Suspicion is enough to report; healthcare workers don't need to be certain abuse has occurred for a report to be made and for child services to investigate.