Health promotion of toddlers: 1-3 yrs Flashcards
“The terrible twos” - describes toddlerhood in gen; three was worse; whole range from 12-36 months
Ages 12-36 months
Intense period of environment exploration - learning about enviornment; can manipulate things or people in environment to get response desired
LOTS - Temper tansturms
LOTS - Negativism
LOTS - Exploration - get into things; come across as destructive; not realize something is bad; testing thing as out
Determined, strong-willed, volatile little tyrant - TRUE; trying get independence desire
Know what want and be upset and tantrums if not get what want
Toddlerhood
Weight gain slows to 4 to 6 lbs/year - infancy growing fast - eat lot food and often; toddlerhood eat less often; not waking up in night to eat; also becoming pickier; not want sit and eat; want sicks - slowing growth
Birth weight should be quadrupled by age 2½ years
Height increases about 3 inches/year
Elongation of legs and arms rather than trunk - long bones growing
Growth is step-like rather than linear - growth spurts - periods quick growth then slow down; quick growth - emotional changes - crabbier, more sleep, eat more
Physical development
Only one sys working at adult level at infancy - hearing; other sys half baked
Most physiologic systems are relatively mature by the end of toddlerhood. - everything conts grow and mature - not fully mature until adolescence - not mean growth wise relatively mature
Maturation of systems
Lungs and internal organs - double in adolescence but not functioning lot better than when born
Ears - short and straight - ability drain fluid - negative pressure - not angle to release pressure - common ear infections; not until school ages that eustation tubes shift that hearing drain fully (aka otitis media) - less ear infections
Big tonsils and adenoids - prevent lot viral infections going deep - protective - big - increases risk UR infections
Exposure - not always exposed to much; toddler - go to daycare and exposed to lot viral illnesses never seen before
Upper respiratory infections, otitis media, and tonsillitis are common among toddlers
Antibodies - work lot better because exposed lot things; virus attacks again - able fight off better; better if go to preschool more antibodies build up
Body temperature is maintained
Child is physiologically able to control elimination
What does this mean?
Start potty training kids
Defense mechanisms of skin are intact - skin matured - not worry as much about topical exposure and absorption
Vision
Continues to improve
Most physiologic systems are relatively mature by the end of toddlerhood. - everything conts grow and mature - not fully mature until adolescence - not mean growth wise relatively mature
15 months – uses a cup well; builds a tower of two blocks
18 months – manages a spoon without rotation; turns pages in a book, two or three at a time; builds tower of three or four blocks
2 years – builds a tower of six or seven blocks; turns pages of books one at a time
2.5 years – draws circles; has good hand-finger coordination
Fine motor skills
15 months – walks without help; creeps up stairs
18 months – runs clumsily and falls often; throws a ball overhand; jumps in place with both feet; pulls and pushes toys
2 years – walks up and down stairs by placing both feet on each step
2.5 years – jumps across the floor and off a chair/step using both feet; stands on one foot momentarily; takes a few steps on tiptoe
Gross motor skills
BIG ONE
Diff are and life more diff - do with how developing cognitively
Sensorimotor
Preoperational phase
Cognitive development
Cognitive processes develop rapidly esp between ages 12 and 24 months
Exploring world through senses and basic motor func now developed
Active experimentation Applying knowledge to new situations - crawling and walking - learn through active experimentation
Complete understanding of object permanence
Imitation of behaviors
Domestic mimicry - BIG; copy what adults do; end phase: mimicing copy same gender pt
Concept of time: Still very embryonic - not understand mins - know warning leaving soon
Can begin to visualize things mentally (ex. If a ball rolls under a table - know under table)
Casual relationships - if flip on lightswitch - light turn on; knowledge not transfer; new lightswitch must test it out and see if does same thing; dangerous; not understand is not safe and is going to be fine; do things over and over because cannot transfer knowledge
Sensorimotor
Cannot think in terms of operations
Preconceptual phase
2-4 years
BIG - Is the transition between self-satisfying behavior and socialized relationships - still egocentric between 2-3 yrs; after this learn social norms; understand other people and how belong in our world
No longer “out of sight, out of mind” - even when hide something know still there; if obsessed with it: will not forget about it and know exists - lot time looking for it or throwing tantrums until find it
Preoperational thought implies children cannot think in terms of operations
Think symbolically
Egocentrism /animism - give lifelike personality/traits to inanimate objects
Global organization - move where bed is - now think changed everything in world, upset and frustrated because not where bed should be
Centration - like focus on one thing; focused on one thing that not focus on other things
Toddler begins to problem solve
Preoperational phase
1-3 yr old
Learns control own body funcs - potty training - BIG
When potty training going on and wets pants - not feel shameful or yell at them as will have accidents but by yelling at them or shaming them causing question themselves and autonomy that they have and whether or not they can successfully accomplish this stage - need + reinforcement - tell ok and can clean it up and not big deal; focusing on allowing have appropriate amt autonomy
Increasingly independent - prefer do things self; want autonomy and assert self - learn control over body and choose what do and not do - leads to negativism
Developing sense of autonomy
Negativism - no or me do - want full control which cannot have; not physically ready; not ready for full control but realizing can have it and make big changes; good to give choices - helps negate negativism and not go away for awhile
Ritualism - like having structure and routine - want things be same; routine is safe for them and comfort zone for them; helps better night sleep; structure and accepting that; routine very imp
Independence
Autonomy versus shame and doubt (Erickson) - Psychosocial and cognitive development
Separation and Individualism
Personal social behavior
*What independent skills can we encourage without the risk of harm?
Social development
Differentiation of self from mother and significant others
Type separation and individualism
Type control and manipulate environment
Know separate
Rapprochement - child separates self from mom; explore environment and come back make sense what experienced; when come back seeking reassurance that what done and experienced norm and ok - safety issue for them; if moms/SO not have appropriate rxn - confuse child and feel insecure, not trusting self can explore world by self, want them have independence
Transitional objects - loveys, teddy bears, feel safe when nervous or unsure surroundings; very helpful; if not have ritualism react poorly if have something from home and something make them safe help reduce anxiety
Typically have gender identity by 3
Separation and Individualism
Toddlers develop skills of independence
Skills for independence may result in determined, strong-willed, volatile behaviors - want do everything themself - if do for them causes tantrums - imp give opportunities to children - give opportunities to them - quicker if we do it - they need prac and learn how do it; need reassurance can do and alright to do it; can be frustrating but encourage it
Skills include feeding, playing, dressing, and undressing self
Toddlers develop concern for the feelings of others (towards the end of toddlerhood) - realize others have feelings towards end and not as egocentric
Personal social behavior
Takes off in toddlerhood
Level of comprehension increases than what able say; know what want but cannot say it - can lead to tantrums/frustration - know what want but cannot explain it to you
As out toddler phase easier it gets
Ability to understand increases
Comprehension is much greater than the number of words a toddler can say
At age 1 year, child uses one-word sentences “holophrases” to mean whole word sentences
By age 2 years, child uses multiword sentences
3 - talking in complex sentences - express self and tell feeling
May not be able understand thing
If language not developing, getting assessed for language delays - work with doc; working with child and feeling like lacking behind - red flag and bring up with doc; discover what is norm for pt in a familiar setting
Language development
Toilet training
Temper tantrums
Negativism
Regression
Discipline toddlers
Age-related concerns
Sphincter control around 18 months - still might not psychological/developmental/have gross motor skills to be ready
Typ start 2 yrs-3yrs
Discuss signs of readiness with parents: stay dry for at least 2 hrs; recognize urge to go - saying I am pooping; after go and immediately want to be changed; taking on and off own clothes; show desire wanting to go - easier if have sibling going; place them on toilet before shower
Reward them for going
Positive experiment - not feel bad if accident
Toilet training
