Growth and Development of Toddler and Preschoolers

Question 1

Toddler period

Answer 1

12-36 months
Time of intense exploration
“how do things work and how can I control others?”

Question 2

Toddlers try to control others with

Answer 2

Temper tantrums
Negativism
Obstinacy
(reassure parents that behaviors are appropriate and needed for intellectual growth and developmental achievements

Question 3

Psychosocial Development: Toddler

Answer 3

Erikson’s Autonomy V Shame and doubt (phase 2: 12-36mo)
Acquire sense of autonomy while overcoming a sense of doubt and shame
Ritualistic behaviors and negativism responding “no” or “me do”
Will throw temper-tantrums when scolded- but need to have a sense of sameness and reliability that will provide a sense of control and help limit some of their outbursts and temper tantrums

Early stages of “super ego” or conscience emerge

Question 4

Cognitive Development: Toddler

Answer 4

Piaget’s sensory motor stages (12-24mo)
Tertiary Circular Reactions begin to emerge
Awareness of casual relationships between 2 events (like turning on a light switch)
Not able to knowledge transfer to new situations, they must reinvestigate what happens
Able to recognize different shapes and their relation to one another
Aware of space and the relationship of their body to dimensions such as height – they can stand and stretch to reach things higher up, pull stings, stand on stools

Question 5

Primary circular reaction:

Answer 5

Action and response both involve infants own body (1-4 mo)

Question 6

Secondary circular reaction:

Answer 6

Action gets a response from another person or object, leading to babies repeating original action (4-8mo)

Question 7

Tertiary circular reaction:

Answer 7

Action gets one pleasing result, leading baby to perform similar actions to get similar result (12-18mo)

Question 8

Piaget’s Final Sensory Motor and Preoperational phase

Answer 8

19-24 mo
More complex preoperational thought
Object permanence (actively seek out objects in several different potential hiding places)
Imitation: symbolization
Mimicry: imitating household activities
Gender role behaviors becomes increasingly common, identify with the same gender parent and attempt to copy them in their gestures and words

Question 9

Piaget’s Per-conceptual/Pre-operational phase of Cognitive Development

Answer 9

2-4yr
Subdivision of per-operational lasts from 2-7yr rudimentary socialized behavior is primary one of transitions that bridges the purely satisfying behavior of infants and the rudimentary socialized behavior of latency
Don’t think in operation/logical fashion-problem solving
Concrete thinkers (basis of their perception of an event only with what they see and hear directly)
Egocentrism, Magical belief
Concerned with why and how of things

Question 10

Physical Development: Toddler

Answer 10

Growth slows 
Birth weight is quadrupled by 2.5yr
Height increases by 3 in per year
FOC = chest circumference by 1-2yr 
Pot belly look
Bowed legs (straighten out between 3-4)
Visual acuity: 20/40
Report persistent strabismus (crossed eye): should disappear between 3-4 mo-- can be fixed if caught soon, if not can lead to vision problems 
Senses become increasingly developed (want to smell, touch, taste... Very curious)

Question 11

Estimation of adult height:

Answer 11

2yr height in cm x 2

Question 12

Gross motor: Toddler

Answer 12

Major development of locomotion
Begin to tiptoe
Steady gait

Question 13

Gross motor: 12-13 mo

Answer 13

Walks independently, using a wide stance for extra balance

Question 14

Gross motor: 18mo

Answer 14

Try to run, but fall easily

Question 15

Gross motor: 24mo

Answer 15

Walk up and down stairs with assistance

Question 16

Gross motor: 30mo

Answer 16

Can jump using both feet

Question 17

Gross motor: Assessing the readiness for Potty training

Answer 17

Voluntary control of anal and urinary sphincters (18-24mo)
Ability to stay dry for 2hr
Decreased number of wet diapers
Waking up dry from a nap
Regular bowel movements
Achieved gross motor skills, such as sitting, walking, squatting
Achieved fine motor skills: able to remove their clothing
Recognize the urge to use the bathroom
Ability to communicate when they need to use the bathroom
Must be able to sit on the toilet for 5-10 minutes without getting up or fussing

Question 18

Fine motor: 12mo

Answer 18

Grasp very small objects

Question 19

Fine motor: 15mo

Answer 19

cast and retrieve objects

Question 20

Fine motor: 18mo

Answer 20

Throw a ball over hand

Question 21

Fine motor: 24mo

Answer 21

Turn pages in a book

Question 22

Fine motor: 30mo

Answer 22

Hold crayon in fingers

Question 23

Fine motor: toddler

Answer 23

Can stack blocks
Draw stick figures
Must incorporate play during hospital stay due to its importance

Question 24

Nutrition for Toddler

Answer 24

Decreased need for protein, calories, fluids
Caloric requirement: 102kcal/kg/day
Require 3 meals and 2 snacks per day
Eat with the rest of the family

Question 25

Physiologic Anorexia

Answer 25

18mo | Become very picky, fussy eaters with a strong taste preference

Question 26

Preventing food jags in toddlers

Answer 26

Prevent one food in various physical forms Child may need to progress to eating new foods in a step wise fashion: seeing food, smelling, touching, tasting it then eating it Normal behavior Want to investigate the food before eating it

Question 27

Nutrition needs for Toddler

Answer 27

Vit C enhance iron absorption Drink from cup with a lid Use a spoon Eat with fingers: make sure its cut up Use routines (can bring routine to hospital) Dont mix food or let them touch Keep serving small: 1 tbsp of solid food/year of age Need vit D supplementation for good bone growth

Question 28

Toddler nutrition: Whole milk

Answer 28

2-3 servings a day (23-30oz) Milk is the cheapest source of Ca and Phosphorus intake Continue whole milk until 2yr then can go to low fat milk to decrease caloric intake

Question 29

Toddler nutrition: Fruit Juice

Answer 29

4-6 ounces of 100% juice = enhances iron absorption Need at least 1 cup of fruit/day because of Vit C enhancing absorption of Iron Dont give more than 4-6 ounces of 100% juice because it will cause diarrhea, DM, dental caries and over and under nutrition

Question 30

Good sources of Ca

Answer 30

``` Cheese Yogurt Milk Beans Green veggys (broccoli, collard greens) ```

Question 31

Ca fortified foods

Answer 31

Waffles Cereals Some white bread OJ

Question 32

Skills and Language development: 15mo

Answer 32

Tolerates separation from parents mometarily

Question 33

Skills and Language development: 18mo

Answer 33

Temper tantrums emerge Show strong emotions Use ownership words If time outs are used its best for the time to be 1 min/year of age

Question 34

Skills and Language development: 24mo

Answer 34

Parallel play | Not good with sharing at this age group, important to start implementing sharing concepts

Question 35

Skills and Language development: 30mo

Answer 35

Separates from parents easily Increased independence from parents Begin to use 400 words, 2-3 word sentences

Question 36

Safety considerations: Toddler

Answer 36

``` Aspiration Suffocation risks Falls Drowning Strangulation Burns (use back burners) MVC (use appropriate car seat) Immunizations ```

Question 37

Safety tips for parents of toddlers

Answer 37

``` Use federally approved car seat Supervise play Supervise child around water Cover outlets Latch second story windows Place gates at top and bottom of stairs Examine toys for small pieces Garage doors need to have safety mechanisms in place Food should be adequately cute Keep toxins out of reach ```

Question 38

Sibling Rivalry in Toddler

Answer 38

occurs when there's a new child in the family and the toddler no longer gets all of the attention and actios out, and may revert to more infantile behavior such as demanding a bottle when they've been weaned off for a few months, or clinging, or soiling underpants This is normal behavior because they are feeling left out Parents should spend as much time with toddler as possible

Question 39

Breathing holding in Toddler

Answer 39

When a child is having a temper tantrum If they are not getting what they want they may hold their breath, it is common and will not be harmed. Make sure of safe environment due to fainting They do this to gain independence and be autonomous Provide them with consistency in expectations and prioritize rituals Have consequences that are reasonable for the development to help manage behavior When the child demonstrates appropriate behavior: provide positive reinforcement about the behavior so that the child knows that the behavior is bad not that they are bad

Question 40

Autism in Toddlers

Answer 40

Diagnosed at 18-36mo 4x more often in Boys than Girls Various therapies can help but no cure Common speech and language delay 🚩If child isn't babbling or gesturing by 12mo 🚩If they are not saying single words by 16mo or 2 word phrases by 24 mo Need to be recommended immediately for hearing and language evaluation ✶Early treatment results in better outcome

Question 41

Common fears and stressors in a hospital for a Toddler

Answer 41

``` Fear of strangers and new places Separation from parents Fear of being abandoned Fear of losing control and autonomy Fear of moving with medical equipment connected to them ```

Question 42

Preschool Age

Answer 42

3-5 yr

Question 43

Preschoolers

Answer 43

Gain control of their bodily functions Most children should be completely potty trained (some are heavy sleepers and need to wear pull ups) Tolerate brief and prolonged periods of separation Interact cooperatively with other children and adults Learn how to share and take turns, learn how to say "thats not fair" or "its my turn" Use language for mental symbolization, make up different names for certain objects Increased attention span and memory ( if you make a promise you have to follow through, they will remember

Question 44

Psychosocial development of Preschoolers

Answer 44

Erikson's Initiative V Guilt (phase 3: 3-5yr) Primary psychosocial task is acquiring a sense of initiative Like to please others and its very important to be accepted by parents and friends Love getting praised for a good job Feeling of guilt, anxiety and fear when their thoughts differ from expectations Development of superego and conscience Learn the difference between right and wrong, good and bad

Question 45

Cognitive Development of Preschoolers

Answer 45

Piaget's Cognitive theory: per-operational phase Less ergocentric- not extremely focused on self Use language without understanding the meaning of words, need to reinforce not to use words that they dont understand the meaning of, pay attention to what they are hearing and listening to Dont have a full understanding of time (days, weeks, months) Thinking is magical, believe their thoughts are all powerful

Question 46

Physical development of Preschooler

Answer 46

Proportions no longer resemble those of that squat, potbellied toddler, they are more slender with a sturdy frame Gain about 5lb every year

Question 47

Average weight and height for 3yr

Answer 47

weight: 14.6kg (32lb) height: 95cm (37.25in)

Question 48

Average weight and height for 4yr

Answer 48

Weight: 16.7kg (36.75lb) Height: 103 cm (40.5in)

Question 49

Average weight and height for 5yr

Answer 49

Weight: 18.7kg (41.25lb) Height: 110cm (43.25in)

Question 50

Motor Function of 3yr

Answer 50

Walking, running, climbing, and jumping well, stands on 1 foot for about 10 seconds, copy circle, build a tower of 9-10 cubes Vocabulary of 900 words, talk using 3-4 sentences combined Ask many questions Dress and feed themselves - need help with buttons, zippers, turning clothes right side out, putting the left and right shoe on correctly, brushing teeth,

Question 51

Motor Function of 4yr

Answer 51

Skip and hop on one foot, catch a ball, throw overhand, walks up and down stairs alternating feet (supervise), use scissors, copy a square, draws 2 part stick figure 1500 word vocab, talks in 4-3 word sentences Imaginary playmates (normal) Very independent

Question 52

Motor Function of 5yr

Answer 52

Skips alternating feet, jumps rope, begins to sate with good balance, walks backwards, ties shoe laces 2100 word vocab, 6-8 word sentences Names 4 or more colors Knows days of week and months but still bad concept of time (use breakfast, lunch and dinner time frames)

Question 53

Nutrition for Preschooler

Answer 53

Picky eaters 1400-1600 calories/day for a moderately active child Fruits, veggy and whole grain should be increased Be aware of sugar-sweeteners Diet must contain adequate Ca, Vit D Decrease fats Serving sizes should be about 1/2 cup portions Quality over Quantity

Question 54

Nutrition By age 5

Answer 54

Become more agreeable to trying new food when encouraged by adults, love helping in the kitchen Ready to social side eating, will sit quietly with family and eat

Question 55

Safety Considerations of Preschooler

Answer 55

``` Supervision when playing anywhere NEVER LEAVE CHILD ALONE AROUND WATER Educate about hazards of the street and learn what the signs mean Appropriate car seat Helmet to prevent head injury Prevent choking by cutting up foods ```

Question 56

Appropriate Car seat

Answer 56

Rear facing used by infants for as long as possible, to the weight limit of the harness Never Forward facing before the 1st birthday and about 20-22lbs When forward facing: toddler must be in a5 point harness until upper weight limit of harness is reached about 40-65lbs Children age 4 and up to 4ft 9in to be in a booster seat

Question 57

Safety in hospital for Preschoolers

Answer 57

Bed in the lowest position Side rails up and locked Call light within reach and teach how to use it Prevent choking on food or objects- cut up food and make sure HOB is elevated appropriately for them to eat