1. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of the Toddler: 1 to 3 Years Chapter 18

2. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Physical Development of the Toddler Time of slowed growth and rapid development Gains 5 to 10 lbs and grows about 3 inches each year Learns to chew food with continued eruption of teeth Learns to stand alone and walk between the ages of 1 and 2 Most say their first words and refine language skills By end of this period, may have learned toilet training

3. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Behavioral Characteristics of Toddlers Negativism Ritualism Dawdling Temper tantrums

4. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Toddler’s Play Moves from solitary play of the infant to parallel play Much of playtime is imitation of role models The toddler does not share toys until later toddler years Toys should involve the toddler’s new gross motor skills Toys should refine fine motor skills

5. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Discipline vs. Punishment Discipline –Needed by all small children to train or instruct to produce a particular behavior pattern –Moral or mental improvement and self-control Punishment –Penalizing someone for wrongdoing –Need occurs much less frequently in small children

6. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Suggestions for Using Discipline Methods Consistency and timing –All caregivers should agree on the methods of discipline and operate by the same rules Person in charge –Teach the child that the adults are in control –Help the child gain self-control while learning to be independent Using “time-out” and “extinction” –Praise good behavior; ignore negative behavior

7. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Reasons for Occurrence of Eating Problems Slowed growth rate –Child may want and need less food than before Strong drive for independence and autonomy –Compels an assertion of will to prove individuality both to self and to others Variable appetite –Varies according to the kind of foods offered –“Food jags” are common

8. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion and Maintenance for the Toddler Routine checkups –Encourage checkups to protect the toddler’s health and ensure continuing growth and development Family teaching –Support positive parenting behaviors –Reinforce the toddler’s achievements Accident prevention –Promote a stimulating environment that is safe from accidents and infection

9. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Assessment Included in Routine Checkups for Toddlers Growth and development Oral hygiene Toilet training Daily health care The caregiver–toddler relationship Parenting skills

10. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Topics for Teaching for the Caregivers of a Toddler Bathing Dressing Dental care Toilet training Sleep Accident prevention

11. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Suggestions for Potty Training the Toddler Use a comfortable potty chair; limit the time on the chair Have the child wash hands afterward to instill good hygiene Use “pull-up” type clothing Allow the 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

12. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Sleep Needs and Practices for the Toddler Sleep needs –1 year of age: 12 to 14 hours –3 years of age: 10 to 12 hours –Toddler gives up a morning nap; continues afternoon nap until about age 3 Sleep practices –Rituals are a common part of bedtime procedures –Regular schedules with set bedtimes are important

13. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Accidents Involving Toddlers Motor-vehicle accidents Drowning Burns Ingestion of toxic substances

14. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Most Common Medications Involved in Childhood Poisonings Acetaminophen Salicylates (aspirin) Laxatives Sedatives Tranquilizers Analgesics Antihistamines Cold medicines Birth control pills

15. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Issues Confronting the Toddler in the Health Care Setting Toddler’s inability to communicate well Complete control by strangers, eliminating self- autonomy Discomfort from pain Separation from family Presence of unfamiliar people and surroundings Physical restraint Uncomfortable or frightening procedures

16. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Components of a Social Assessment Survey Eating habits and food preferences Toileting habits and terms used for toileting Family members and the names the child calls them The name the child is called by family members Pets and their names Favorite toys Sleeping or napping patterns and rituals

17. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Minimizing Eating Problems for the Toddler in a Health Care Facility View mealtime as a social event Encourage self-feeding Do not push the child to eat Allow others to eat with the child Offer familiar foods Provide fluids in small but frequent amounts