Toddler 2015
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Transcript of Toddler 2015
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THE TODDLER(1-3 years old)
Ma.Elizabeth N. Jurado
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BIOLOGIC AND PHYSICALDEVELOPMENT
Weight, Height and Head
Circumference
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Ave. wt gain- 1.8 to 2.7
kg (4-6 lbs)/ yr; 4xthe BW by 2 ½ yearsold
Ave. ht increase- 86.6cm (34 in); 7.5 cm or
3 inches per year;occurs mainly in theelongation of the legs
than the trunk
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Adult height is about twice the
2 year old child’s height Subcutaneous tissues or baby
fat begins to disappear Decreased appetite
Chest circumference exceedsthe head and abdominal
measurements
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Body Contour
“pot- bellied” appearance slightly bowed and curved
legs lordotic- forward curve
of the spine at thesacral area
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Maturation of Body Systems
internal structures of theear and the throat areshort and straight
RR slows but mainly
abdominal HR slows from 110 to 90;BP increases to 99/64
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Brain develops to about90% of its adult size
More developed GIfunctions; has voluntarycontrol of elimination
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By 14-18 mos of age,
the child can retainurine up to 2 hrs orlonger
18-24 mos (completemyelination of the
spinal cord), canretain urine up to 2hours or longer
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phagocytosis more efficient IgG and IgM antibody
production becomes mature;passive immunity effectsfrom intrauterine life areno longer operative
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Teeth
Eight new teeth eruptAll 20 deciduous teethare generally presentby 2 ½ to 3 years
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Sensory Changes
20/40 visual acuity full binocular vision sense of hearing, taste,
smell and touch increasingly
well-developed development of specifictaste preferences
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FINE MOTOR DEVELOPMENT Age Movement
15 months Puts small pellets in smallbottles; scribbles; holds a spoonbut may still turn it upside downon the way to the mouth
24 months Can open doors by turningdoorknobs
30 months Makes simple lines or strokesfor crosses with a pencil
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GROSS MOTOR DEVELOPMENT Age
Movement15 months Walks alone well; can seat well on
chair; can creep upstairs
18 months Can run and jump in place; canwalk up and down the stairsholding on to someone placing bothfeet on one step before advancing
24 months Walks upstairs alone using bothfeet on same step at the sametime
30 months Can jump down from stairs
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PSYCHOSOCIAL DEVELOPMENT
described by Erickson as the stage ofautonomy vs shame and doubt
pride in new accomplishments wants to be independent children should be allowed to do their
part not all things are to be done for them
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PSYCHOSEXUAL DEVELOPMENT
Described as the anal phase
by Freud Aware of gender differences
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COGNITIVE DEVELOPMENT 15 months to 2 years
- sensorimotor phase- “little scientists”- able to remember an action
then imitate it later 2-3 years old
- preoperational thought- deal constructively with symbols- ready for toilet training
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MORAL DEVELOPMENT
parents must not equate the childas being “good” or “bad” if he
can or cannot do a task such aswalking, voiding or defecating inthe proper place
material or emotional bribes rarelyeffective punishment-obedience principle
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SPIRITUAL DEVELOPMENT
intuitive-projective faith faith and religion is learned
from significant othersin the environment development of conscience behaves correctly to avoid
punishment
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LANGUAGE DEVELOPMENT Greatly affected by the
environment Requires intact physiologic
structures and function,intelligence, need tocommunicate and stimulation
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At the age of 2, vocabulary
increases from 300 to 2100words at the end of 5years old
Gives and follows simple commands
Nouns; verbs; adjectives;adverbs; pronouns; genderwords
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To master language:
- practice talking- don’t baby talk-
expose to conversation- read often-
answer questionsbriefly and in simpleterms
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PLAY DEVELOPMENT
Parallel play Toys that require action Parents should not correct
children about the way a
toy is being used as longas it appears to givesatisfaction
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SPECIAL NEEDS OFTHE TODDLER AND
THE APPROACHES TOMEET THESE NEEDS
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LOVE AND SECURITY
Enables the toddler togrow up and reach outfor more mature roles
The mother is still the oneto turn to for physicalcare
The father is hardly known
till toddler stage
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Security or Transitional Object
- an object which has unusualimportance and whichseems to provide securityfor the child (e.g. pillows,blankets,dolls)
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GRADED INDEPENDENCE
Learned gradually and given onlyif he can guard himself fromtrauma A very painful experience mightmake a child afraid to try outnew skills
Develops a sense of self-relianceand adequacy of autonomy
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Learns that there are many
things he would like to do,but cannot or may not
An adult should never use shameor ridicule as a means ofpunishment or ofprevention of forbiddenactivities
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AREAS WHERE GUIDANCE ARENEEDED:
1. elimination control
2. learning language
3. learning social norms
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LEARNING SOCIAL NORMS
- “standard”-
learn simple and basicmovements in washing andbathing self
-
must understand discipline
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DISCIPLINE
Qualities of A ConstructiveDiscipline
1.consistency2.clarity3.firmness4.immediacy5.encouragement of independence
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overdemanding and “laissez -faire” parents fail indisciplining their children
Punishment-results frombreakdown in discipline Taking time-out – 1 minutefor each year up to 5minutes-over 5 years:maximum of 5 minutes
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CONTROL OF BODILYFUNCTIONS
Requirements For Toilet TrainingPhysical maturity
-
control of rectal and urethralsphincter with completemyelination of spinal cord
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Psychological readinessa. recognition of the urge to
hold on and let go; ability tocommunicate this to themother
b. desire to please the mother(by holding on) rather thanto please oneself (by lettinggo) anytime
c. developmental abilities (e.g.to sit,walk)
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Principles of Toilet Training
1. Bowel training should bestarted first beforebladder training
2. Toilet training should notbe started earlierthan 18 months
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3. Bladder training shouldbe started 1 month ormore after bowel
a. day bladder training-established at 2 years
b. night bladder- at 3 years
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4.Training should not bestarted when thechild is ill.
5.Mother’s attitude
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Steps in Toilet Training
1. Observe child’s usual time fordefecation.
2. Use of training pants that canbe pulled down readily
3. Use of comfortable child’stoilet seat/ potty chair
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4.Do not give toys or food thatmay distract him
5.Practice session should belimited to 5-10 minutes
6.Do not flush toilet while childis sitting on it
7. Praise child if he urinates ordefecates
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FECAL SMEARING- 15- 18 months- considers warm feces as gifts- parents should not express
strong disapproval
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PROBLEM AREASOF
A TODDLER
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NEGATIVISM- 18 – 30 months- attempt to assert oneself
as an individual-
a loud “NO” automaticallyeven if they mean yes
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Mgmt:- should not use opposition
to overcome opposition-
don’t ask questions thatwill require a yes or noanswer
-
participate (physical help)- recognize signs of
independence
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RITUALISTIC BEHAVIOR
-
makes rituals of simple task
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TEMPER TANTRUMS-
violent outburst of behavior- best managed byignoring the behavior
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Mgmt:
- remove cause- be calm and patient- protect from harm/
injury; no extraattention
- avoid restraining
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DAWDLING- slowness in carrying a task
Causes:- task may be difficult- to avoid trying a task he knows
he cannot do- confusion
Mgmt:- specific instructions- help child perform task
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SEPARATION ANXIETY- attachment to mother
is possessive andselfish
- greatest fear: abandonment
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Mgmt:-
give transitional object- practice makes perfect
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BASIC NEEDS
OFA TODDLER
1 Bathing
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1.Bathing2.Clothing3.Sleep and Exercise
- 12 to 14 hours of sleepincluding daytime napof 1-2 hours
- with set of bedtime
rituals4.Care of the teeth – 2 ½years: social visit
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5. Nutritional needs-
decrease rate of growthwill decrease caloricrequirement, CHON
and fluid intake- manifested by decreaseappetite known as
physiologic anorexia- 100 kcal/BW- eating time=happy time
P i f f di
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Points for feeding Serve food in small portion
Needs 3 well balanced dietwith snacks
Chop or cut food in smallpieces
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6. Health Supervision- immunization- dental care-
establish good habits7. Accident Prevention
– childproof the house
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