Human Growth and Development NUR 311 Growth and Development of Toddler Stage Lecture 5

1. Human Growth and DevelopmentNUR 311Growth and Development of Toddler StageLecture 5

2. Physical Growth While toddlers are making great strides developmentally, their physical growth begins to slow ►Weight - A child gains only about 2.5 kg and 12cm a year during the toddler period. - A toddler‘s appetite decreases accordingly, yet adequate intake of all nutrients is still essential to meet energy needs.

3. ►Head circumference - Increases only about 2 cm during the second year compared to about 12 cm during the first year. - By 2 years, chest circumference has grown greater than that of the head.

4. ►Body Contour - Toddlers tend to have a prominent abdomen –because although they are walking well, their abdominal muscles are not yet strong enough to support abdominal contents. - They have a forward curve of the spine at the sacral area (lordosis).

5. ►Body systems • -Body systems continue to mature during this time. • - Respirations slow slightly but continue to be mainly abdominal • - The heart rate slows from 110 to 90 bpm; blood pressure increases to about 100/65 mm Hg. • - The brain develops to about 90% of its adult size.

6. - Stomach secretions become more acids; therefore, gastrointestinal infections become less common. - Stomach capacity increases to the point a child can eat three meals a day. - Control of the urinary and anal sphincters becomes possible with complete myelination of the spinal cord. - IgG and IgM antibody production becomes mature at 2 years of age.

7. ►TEETH Eight new teeth (the canines and first molars) erupt during the 2nd year. All 20 deciduous teeth are generally present by 2.5 – 3 years of age.

8. Developmental Milestones ►Language Development In order to master language, children need practice time. A word that is used frequently by toddlers and that is a manifestation of their developing autonomy is a “no”. Toddlers may use the word to mean they are refusing a task, or they do not understand it.

9. To learn other words, children need exposure to conversation. Urge parents to encourage language development by naming objects as they play with their child. Always answering a child’s questions is another good way to do this. Be sure answers for toddlers are simple and brief because they have such a short attention span.

10.   Emotional Development 1- Autonomy – The developmental task of the toddler years according to Erikson is the development of a sense of autonomy vs. shame or doubt. • To develop sense of autonomy is to develop a sense of independence. - A healthy level of autonomy is achieved when parents are able to encourage independence while still maintaining consistently sound rules for safety

11. 2- Socialization • Fifteen-month old children are still enthusiastic about interacting with people. • By 18 months, toddlers imitate the things they see a parent doing. • By 2 or more years, children become aware of gender differences.

12. Planning and Implementation for Health Promotion of a Toddler and Family Toddler tend to develop many upper respiratory and ear infections but otherwise come to health care facilities most often for health maintenance visits (recommended each 3 months during the 2nd & 3rd years) and immunizations important at these times.

13. Promoting Toddler Safety • Accidents are the major cause of death in children of all ages. • Accidental ingestions (poisoning) • motor vehicle accidents • Burns • falls and playground injuries

14. Promoting Nutritional Health of a Toddler Toddlers usually do not like food that is “mixed up”. Toddler Nutrition Children ages 1 – 3 years should consume 1,300 kcal daily.

15. Promoting Toddler Development in Daily Activities Dressing • By the end of the toddler period, most children can put on their own socks, underpants and undershirt. • They invariably put shoes in the wrong feet and shirt and pants on backwards.

16. Sleep • They may begin the toddler period napping twice a day and sleeping 12 hours each night, • End it with one nap a day and only 8 hours sleep at night.

17. Bathing • Toddlers usually enjoy bath time and parents should make an effort to make it fun by providing a toy. • Remind parents that although toddlers can sit well in a bathtub, it is not safe to leave them unsupervised

18. Care of Teeth • Toward the end of Toddler period, they can begin to do brushing themselves under supervision. • After brushing, parents can use dental floss to clean between the child’s teeth and remove plaque. • Visit to a dentist skilled in pediatric dental care by 2.5 years of age for assessment of dentition.

19. Parental Concerns Associated with the Toddler Period Toilet Training Before children can begin to be toilet trained, they must have reached important developmental levels one physiologic and the other cognitive: ● They must have control of rectal and urethral sphincters, usually achieved at the time they walk well. ● They must have cognitive understanding of what it means to hold urine and stools until they can release them at a certain place and time.

20. Ritualistic Behavior ►Negativism Their reply to every request is a definite “no.”

21. ►Discipline Remind parents that “discipline” and “punishment” are not interchangeable terms. ● Discipline means setting rules or road signs so children know what is expected of them. ● Punishment is a consequence that results from a breakdown in discipline, from the child’s disregard or the rules that were learned. Two general rules to follow: ● Parents need to be consistent ● Rules are learned best if corrected behavior is praised rather than wrong behavior punished

22. ► Separation Anxiety Fear of being separated from parents begins at about 6 months of age and persists throughout the preschool period.

23. ►Temper Tantrums • Almost every toddler has a temper tantrum at one time or another. • The child may scream, shout “No,no,no” lie on the floor. • Children may hold their breath until they become cyanotic and slump to the floor.