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Growth and Development of the Toddler: 1 to 3 Years

الكلية كلية التمريض     القسم قسم التخصصات التمريضية     المرحلة 3
أستاذ المادة عبد المهدي عبد الرضا حسن الشحماني       21/04/2019 17:37:24


Growth and Development of the Toddler: 1 to 3 Years

Objectives:
1. Identify the gross motor development in the toddler.
2. Recognize the fine motor development in the toddler.
3. Recognize the language skill development in the toddler.
4. Explain the psycho-social development in the toddler.
Cont. objectives
5. Explain the cognitive development in the toddler child
6. Identify the health promotion and health maintenance of the toddler
7. Recognize the health problems in the toddler age period and the nurse s roles/actions in dealing with the toddler
Out line:
Physical growth
Physiological growth
Motor development
Language development
Cognitive development
Emotional development
Psychosocial development
Common health problems.
Normal Toddler (1 to 3 years)
Normal toddler: (1 to 3 years of age).
During this period, growth slows considerably.
During these years, children begin the long process toward independence.
Toddler develops from having no voluntary control to being able both, to walk and speak.
They also learn to control their bladder and bowels, and they acquire all kinds of information about their environment.
Gaining self-control mastering tasks such as walking, jumping, dressing, and eating, and learning to use language to express needs.
Physical Development of the Toddler
Time of slowed growth and rapid development
Learns to chew food with continued eruption of teeth
Masters tasks such as walking, jumping, dressing, eating, use language to express needs
Learns to stand alone and walk between 1 and 2 years
Most toddlers say their first words and refine language skills
By end of this period, may be toilet trained
Physical Growth:
? ِAverage weight gain is 1.8 to 2.7 Kg/year. Formula to calculate normal weight of children over 1 years of age:
(Age in years x 2) + 8 = ---- Kg)
E.g. 2 years old child weight = 2 x 2 + 8 = 12 Kg.
? *Toddlers are usually chubby, with relatively short legs and large head. The face appears small when compared to the skull, but as the toddler grows. These proportions gradually change to that of the adult size.
Height:
It increases about 10 to 12.5 cm/year.1-2 years increases 1 cm /month.
Formula to calculate normal height of children over 1 year of age:
(Age in years x 5 + 80 = -----cm)
E.g. length of 2 years old child =
(2 x 5)+ 80 = 90 cm.
Head and Chest Circumferences:
From 1 year to adult the head increases 10 cm only.
During toddler years, chest circumference continues to increase in size and exceeds head circumference.
Anterior fontanel closes between 12 - 18 months of age.
Teething:
By 2 years primary dentition of 16 teeth and
20 teeth by 30 months (2 1/2 years).
Abdomen:
It is a protruded and toddler appears pot-belled because of the immature abdominal musculature. Abdomen flattening results from development of abdominal muscles.
Bow-legs typically persist along toddlerhood since they must bear the weight of the large trunk.
Bowel and bladder control:
Daytime control of bladder and bowel control
by 24 - 30 months.
Senses:
Binocular vision is well developed by 15 months of age.
Visual acuity of 6/6 is achieved during this period.
Senses of smell, hearing, touch, and taste increasingly well developed.
Accommodation well developed.
Physiological Growth:
* Pulse: 80-130 beats / minute (average 110 / min)
* Respiration: 20-30 breath / min.
*Blood pressure: Systolic 95-105mm Hg
Diastolic 53-66 mm Hg
Motor Development:
Language Development:
15th month: Says 4 to 6 words (mainly names).
18th month: Says 10 words or more.
24th month: Vocabulary of almost 300 words. Uses 2-3 word phrases sentence.
30th month: Talks constantly.
Uses plurals and names one color.
And gives first and last name.
Emotional Development:
Tolerates to some extent separation from parent, but he develops separation anxiety (anxiety develop when he is separated from the caregivers-mother).
Less fear to strangers (places and people)
Beginning to imitate parents.
Expresses emotions has temper-tantrums.
Beginning awareness of ownership (my-toy).
The types of play toddler engage in can be described as:
Parallel plays: the child sits with other children but does not cooperate or interact with them.
Much of playtime is imitation of role models
The toddler does not share toys until later of the toddler years
Toys should involve the toddler’s new gross motor skills
Toys should refine fine motor skills
Parallel play
Psychosexual development:
According to Freud, the age 2-3 years represent the anal phase of development which is characterized by:
1. Negativism
2. Emotions expressed very strongly
3. Temper tantrums
Psychosocial development
According to Erickson, toddlers are working on the developmental task of autonomy versus shame and doubt.
The favorite word of most toddlers is “NO”. just saying the word seems to command the attention of those around themselves.
When the central development task is autonomy versus sham& doubt (I can do it my self) increasing abilities to control their bodies themselves, and their environment.
They want to do things for themselves, using their acquired motor skills, E.g. walking, climbing ----etc., their mental power of selection and decision-making.
If they feel small or when they are forced to be dependent on others, feeling of doubt and shame arise.
They slowly gain control over their emotions and need guidance from their parent to be patient and use measures to control limits.
Notice sex differences and knows own sex.
Health promotion & protection
Immunizations
Injury prevention
Sleeping pattern
Nutrition requirement: need 100 kcal/kg/24hrs.
1. They prefer to feed themselves, so they can be at risk of aspiration of small foods that are not easily chewed.
2. Encourage self-feeding
3. Do not push the child to eat
4. Allow others to eat with the child
5. Offer familiar foods
6. Provide fluids in small but frequent amounts
Common Health & Developmental Problems of the toddler:
1. Stranger anxiety.
2. Stressful reaction to hospitalization.
3. Fear. (Large animals, going to sleep, loud noises, loss of parents)
4. Ritualistic behaviors (the same rituals at time of bathing, eating, sleeping)
5. Dental caries.
6. Discipline.
7. Child abuse
8. Toilet training (is one of several critical
training situations)
9. Accidents:
a. Automobile accidents.
b. Burns.
c. Falls.
d. Poisoning. (e.g. lead & Salicylate
poisoning)
10. Infections:
Otitis media and brain abscess because the Eustachian tube (From pharynx to middle ear is straight & shorter than the adult)

Suggestions for Potty Training the Toddler
Use a comfortable potty chair; limit the time on the chair
Have child wash hands afterwards to instill good hygiene habits
Use “pull-up” type clothing
Allow child to observe role model using toilet
Do not flush the toilet while the child is sitting on it
Do not tease or shame the child
Do not expect perfection; lapses occur
Potty Training the Toddler
Sleep Needs and Practices for the Toddler
Sleep needs
1 year: 12 to 14 hours; by 3 years: 10 to 12 hrs
Gives up a morning nap; continues afternoon nap until about age of 3 years
Sleep practices
Rituals are a common part of bedtime procedures
Regular schedules with set bedtimes are important


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