Child Development
Nutrition:
Age: | Proper Nutrition: |
Infant - 4 months | Breast milk or iron fortified formula only (*no cows milk) – WHO recommends exclusive breastfeeding until 6 months Should be held for feedings Signs of hunger: sucking motions and rooting – crying is a late sign |
4 - 6 months | Should be able to sit upright before the introduction of solid foods
Start with rice, oatmeal, and wheat cereals mixed with breast milk or formula, then move to pureed fruits and vegetables
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6 - 8 months | *Finger foods – let baby try to feed themselves (do not force feed)
Can give 1-2 oz of diluted juice (non-citrus) |
8 - 10 months | Need for breastmilk and formula is decreased May eat 3 meals a day (mashed or finely minced), with healthy snacks Try introducing meat for protein (must be shredded) |
10 - 12 months | Can eat things that are soft and starting to chew on things like raw vegetables Trying to feed self with a spoon |
1 - 3 years | Can still be using extended breastfeeding Wean from bottle to cup 15-18 months *Need diet high in calcium and iron – milk intake 16-24 oz per day Offer new foods many times – if they refuse do not substitute with an unhealthy choice Do not restrict fat intake for toddlers over 2 Room temperature, bite size, and using child-size utensils
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3 - 6 years | Offer a healthy diet high in calcium and iron with some fat *3-4 year olds will often have food ‘jaggs’ (want just one specific food always)
Obesity starts to come into play – children at or above 95% have a 50% chance of being obese adults |
6 - 12 years | 1400 - 2100 calories per day *important to establish regular meal times and offer healthy snacks
Prevent obesity (fat cells of childhood are carried into early adulthood) |
12 - 18 years | More independent with their eating habits but an inadequate diet can slow growth and sexual maturation |
Developmental Milestones:
Age | Gross Motor | Fine Motor | Language | Social and Cognitive | Concerns / Safety |
1 month | Head lag (head hanging back when lifted) | Clenched fits – strong grasp reflex | Fixates on objects | Feels safe with caregiver | |
2 - 3 months | Holds head on shoulders | Opened hand (grasp reflex disappears) | Makes sounds and interacts | Interacts with familiar faces | |
4 months | No head lag, rolling from back to side | Grasps with two hands | Laughs and squeals | Soothing and imitating | |
5 - 6 months | Able to roll over | 5 months: palmar grasp – grasping without the thumb 6 months: holds bottle | Babbles and responds to name | Separation anxiety begins | |
7 - 8 months | Can sit forward with hands bearing weight, then unsupported | Transfers objects and starting to use pincer (using thumb and index finger to hold small things) | Strings babbling | Continuation of separation anxiety | |
9 months | Can pull up on something to stand, and can ‘creep’/crawl | Crude pincer grasp | Responds to name | Purposeful play | Report if not babbling |
10 months | Can prone to sit | Grasp rattle handle | Makes sounds and mimics gestures, | Plays peek-a-boo and understands | |
11 months | Can walk with hands on object | Neat pincer grasp | Understands yes and no | object permanence | |
12 months | Can walk holding someone's hand | Can build a 2-block tower | (10-12 m) | (10-12 m) | Concern of SIDS until 1 year – unknown cause, pacifier can help |
12 - 15 months | Walks unassisted and can creep up stairs | Points with index finger, uses cup well, and can feed themselves finger foods | Understands words without context, commands followed by a gesture, and looks at adults while communicating – first words, communicates desires | 1 - 3 years Starting to be focus on separation and self (*egocentric) Has power struggles and temper tantrums Relies on routines and security items | |
18 months | Throws a ball overhand, pulls toys while walking, jump in place, and run clumsily | Manages a spoon, can stack 3-4 blocks, masters reaching, grasping, and releasing, and can remove socks and shoes | Understands the word ‘no’, can sometimes answer the question ‘what is this’ – uses 5-20 words | *Looking for control over the environment – need to offer limited choices No clear body boundaries | Concerned if not walking, not speaking 15 words, or does not understand function of common household items |
24 months | Can kick a ball, walk up and down stairs (both feet on each stair), climb down from furniture, and carries toys while walking | Builds a tower of 6 or 7 blocks and can turn pages of a book | Points to named body parts and named pictures in books – uses 50-300 words, 2-3 word sentences, ⅔ words understood | Separation anxiety may re-emerge Decisions for actions based on avoiding punishment and attaining pleasure Look for autism during this time | Concerned if not using two-word sentences, not imitating actions, not following basic instructions, or cannot push a toy with wheels |
30 - 36 months | Jump across floor and off chairs, can stand on one foot and on tip toes | Good hand-finger coordination and can draw circles | Understands most sentences, can follow a 3 part command – 1,000 words by 3 years, asks why questions | Concerned if having difficulty with stairs, falling frequently, extreme difficulty if having issues with separation from parent, and if there is little interest in other children 1-3 years Period of intense exploration, time for potty training, never leave alone in care of young sibling *helpless in water **lead poisoning | |
3 - 4 years | Ride a tricycle, alternate feet going up and down stairs, move backwards and forwards | Dressing independently, drawing circles, squares, and tracing capital letters, ties shoes | Speaks in complete sentences with grammar, understands concepts of same and different, asks a lot of questions, can count a few numbers | 3-6 years Vivid imagination, magical thinking Developing social skills – making friends, self control | 3-6 years Likely to explore and hide in new places that may be dangerous Tend to be reckless – ideal age to teach about safety and dangers |
5 years | Stands on one foot 10 seconds or longer, swings and climbs well, can learn to skate and swim | Printing some letters, uses fork, spoon, and knife, mostly cares for own toileting needs | Can explain how an item is used, can count to 10, speech should be completely intelligible, can say name and address, talks about past, and future events | Strong emotions Developing identity Lying is common Can use transduction when reasoning | Do not misinterpret comprehension with ability to make safe choices |
6 - 12 years | Slow progressive physical growth, increase in coordination (can participate in organized sports) | *unable to judge speed and distance of oncoming cars until around 10 years | Possesses ability to read – improves with exposure Metalinguistic awareness – enjoys jokes and riddles | Developing self worth from school and community accomplishments Attempts to think through actions and anticipate outcomes, Understands principles of conservation | ADHD may emerge at this time (characterized by inattention, hyperactivity, and impulsivity) – boys are more likely to have it than girls, and medication and therapies can help Increased exposure to dangerous situations Very physically active during this time – injury precautions |
12 - 18 years | Develop endurance, speed, and accuracy and coordination improves | Precise hand eye coordination and finger dexterity | Vocabulary will improve | Want to be autonomous and avoid shame from peers Becoming self dependent Idealistic – committed to their own viewpoint Self esteem tied to body image | Safety risk education is important – physical injuries are the greatest cause of death (due to strength and confidence they feel)
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Developmental Theories:
Ages | Erikson’s Psychosocial Theory | Piaget’s Cognitive Theory |
Infancy (birth - 1 year) | Trust vs. Mistrust Child learns to trust as needs are met by the caregiver – if needs are not met they will develop mistrust Caregivers respond to basic infant needs, infants realize they are separate beings and allow for some time delays | Sensorimotor – birth to 2 years Infant use senses and motor skills to learn about the world (6 stages)
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Toddlers (1 - 3 years) | Autonomy vs. Shame/Doubt Child becomes more independent with an “I am a big kid” frame of mind – separates from caregiver(s) Cannot take turns until around 3 years Starts to have some control over body functions Parallel play during this phase | Preoperational – 2 to 7 years Application of language, use of symbols to represent objects Abe to think about things and events that are not immediately present and are oriented to the present |
Preschoolers (3 - 6 years) | Initiative vs. Guilt Development of a conscience and learning right and wrong Associative play at this stage Children who are criticized for autonomy will develop doubt in their abilities | Thinking is influenced by fantasy and teaching must account for this and their undeveloped sense of time |
School Age (6 - 12 years) | Industry vs. Inferiority Develops interests and takes pride in their accomplishments – projects are enjoyable Displaying rule following behavior Forming social relationships is seen as important – enjoys working in groups Industry provides purpose and confidence Cooperative play in this stage | Concrete Operational – 7 to 11 years Shows an increase in accommodation skills Develops the ability to think abstractly and make rational judgment about concrete/observable phenomenon When teaching give opportunity to ask questions and explain things to the nurse (teach-back method) – allows them to mentally manipulate the information |
Adolescents (12 - 18 years) | Identity vs. Role Confusion Preoccupied with appearance and what others think of them – peers are very important Working on establishing their own identity – trying out roles to see what fits Some confusion is good and leads to self reflection and self examination | Formal Operational: 11 years to adulthood This stage brings cognition to its final form, the individual no longer needs concrete objects to make rational judgments Capable of hypothetical and deductive reasoning Teaching a this age is wide ranging because of many possibilities from several perspectives |