Human Growth and Development NUR 311 Growth and

Human Growth and Development NUR 311 Growth and Development of Toddler Stage Lecture 5 1 LECTURE 5

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 12 cm 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. 2 LECTURE 5

►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. 3 LECTURE 5

►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). 4 LECTURE 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. 5 LECTURE 5

- 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. - Ig. G and Ig. M antibody production becomes mature at 2 years of age. 6 LECTURE 5

►TEETH Eight new teeth (the canines and first molars) erupt during the 2 nd year. All 20 deciduous teeth are generally present by 2. 5 – 3 years of age. 7 LECTURE 5

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. 8 LECTURE 5

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. 9 LECTURE 5

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 10 LECTURE 5

2 - Socialization Ø Fifteen-month old children are still enthusiastic about interacting with people. Ø By 18 months, toddlers imitate things they see a parent doing. Ø By 2 or more years, children become aware of gender differences. 11 LECTURE 5

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 2 nd & 3 rd years) and immunizations important at these times. 12 LECTURE 5

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 13 LECTURE 5

Promoting Nutritional Health of a Toddlers usually do not like food that is “mixed up”. Toddler Nutrition Children ages 1 – 3 years should consume 1, 300 kcal daily. 14 LECTURE 5

Promoting Toddler Development in Daily Activities Dressing Ø By the end of the toddler period, most children can put on their own socks, underpants and undershirt. Ø They invariably put shoes in the wrong feet and shirt and pants on backwards. 15 LECTURE 5

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. 16 LECTURE 5

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 17 LECTURE 5

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. 18 LECTURE 5

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. 19 LECTURE 5

Ritualistic Behavior ►Negativism Their reply to every request is a definite “no. ” 20 LECTURE 5

►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 21 LECTURE 5

► Separation Anxiety Fear of being separated from parents begins at about 6 months of age and persists throughout the preschool period. 22 LECTURE 5

►Temper Tantrums ü Almost every toddler has a temper tantrum at one time or another. ü The child may scream, shout “No, no” lie on the floor. ü Children may hold their breath until they become cyanotic and slump to the floor. 23 LECTURE 5