LERARNING OUTCOMES
➢
DETERMINE THE NORMAL GROWTH AND DEVELOPMENT OF TODDLER AND PRESCHOOLER
➢
ASSESS THE TODDLER AND PRESCHOOLER DEVELOPMENTAL MILESTONE
➢
FORMULATE NURSING DIAGNOSES RELATED TO TODDLER AND PRESCHOOL GROWTH AND
DEVELOPMENT
➢
PLAN NURSING CARE TO MEET A TOD DLERS AND PRESCHOOLER’S GROWTH AND
DEVELOPMENT NEEDS, SUCH AS PLANNING AGE -APPROPRIATE PLAY ACTIVITIES.
➢
EVALUATE EXPECTED OUTCOMES FOR ACHIEVEMENT AND EFFECTIVENESS OF CARE
➢
INTEGRATE KNOWLEDGE OF GROWTH AND DEVELOPMENT WITH NURSING PROCESS TO
ACHIEVE QUALITY MATERNAL AND CHILD HEALTH NURSING CARE.
INTRODUCTION
ALL CHILDREN PASS THROUGH PREDICTABLE STAGES OF GROWTH AND DEVELOPMENT AS
THEY MATURE. PARENTS OFTEN ASK WHAT TO EXPECT FROM THEIR CHILDREN REGARDING
THEIR DEVELOPMENTAL PROGRESS AT HEALTH CARE VISITS. SUCH VISITS PROVIDE
OPPORTUNITIES FOR YOU NOT ONLY TO ASSESS PRESENT GROWTH AND DEVELOPMENT BUT
ALSO TO SUPPLY ANTICIPATORY GUIDANCE ON THE TOPIC. FOR THESE REASONS, INCLUDING
GROWTH AND DEVELOPMENT IS ESSENTIAL IN THE ESTABLISHMENT OF COMPLETE AND
EFFECTIVE NURSING CARE PLANS FOR CHILDREN. THIS CHAPTER ADDRESSES THE MOST
IMPORTANT FACTORS TO ASSESS FOR EACH AGE GROUP PARTICULARLY TODDLER AND
PRESCHOOLER STAGE.
RLE 107
Growth and Development: Toddler and Preschooler
TODDLER
AGE: 1- 3 YEARS OLD
ENORMOUS CHANGES TAKE PLACE IN A CHILD.
CHILDREN ACCOMPLISH A WIDE ARRAY OF DEVELOPMENTAL TASKS AND CHANGE FROM
LARGELY IMMOBILE AND PREVERBAL INFANTS WHO ARE DEPENDENT ON CAREGIVERS
FOR THE FULFILLMENT OF MOST NEEDS TO WALKING, TALKING YOUNG CHILDREN WITH
A GROWING SENSE OF AUTONOMY (INDEPENDENCE)
PARENTS
TO MATCH THIS GROWTH, PARENTS MUST ALSO CHANGE DURING THIS PERIOD. IF A
PARENT ENJOYED BEING THE PARENT TO AN INFANT BECAUSE TIME COULD BE SPENT
ROCKING OR SINGING TO THE CHILD, THEY MAY NOT ENJOY BEING THE PARENT OF A
TODDLER AS NOW THEIR TASK IS TO SUPPO RT THEIR CHILD’S GROWING
INDEPENDENCE WITH PATIENCE AND SENSITIVITY AND TO LEARN METHODS FOR
HANDLING THE CHILD’S FRUSTRATIONS THAT ARISE FROM THE QUEST FOR
AUTONOMY
RLE 107
Growth and Development: Toddler and Preschooler
PHYSICAL GROWTH
While toddlers are making great strides developmentally, their physical growth begins
to slow.
WEIGHT, HEIGHT, AND HEAD CIRCUMFERENCE
A child gains only about 5 to 6 lb (2.5 kg) and 5 in (12 cm) a year during the toddler period,
much less than the rate of infant growth.
Subcutaneous tissue, or baby fat, begins to disappear toward the end of the second year,
the child changes from a plump baby into a leaner, more muscular little girl or boy.
A toddler’s appetite decreases accordingly, yet adequate intake of all nutrients is still
essential to meet energy needs
Head circumference increases only about 2 cm during the second year compared to about
12 cm during the first year. Head circumference equals chest circumference at 6 months
to 1 year of age.
By 2 years, chest circumference has grown greater than that of the head.
RLE 107
Growth and Development: Toddler and Preschooler
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 as well as
they will later
LORDOSIS - a forward curve of the spine at the sacral area
RLE 107
Growth and Development: Toddler and Preschooler
BODY SYSTEMS
HEART RATE – SLOWS FROM 110 TO 90 BEATS PER MINUTE
BLOOD PRESSURE - INCREASES TO ABOUT 99/64 MM HG
BRAIN - DEVELOPS TO ABOUT 90% OF ITS ADULT SIZE.
RESPIRATORY SYSTEM – SLOWS BUT MAINLY ABDOMINAL RESPIRATION. T HE LUMENS OF
VESSELS ENLARGE PROGRESSIVELY SO THE THREAT OF LOWER RESPIRATORY INFECTION
BECOMES LESS.
STOMACH – SECRETIONS BECOME MORE ACID AND STOMACH CAPACITY INCREASES
SPHINCTERS – URINARY CONTROL AND TOILET TRAINING ARE POSSIBLE
ANTIBODIES – MORE MATURE
TEETH - EIGHT NEW TEETH (THE CANINES AND THE FIRST MOLARS) ERUPT DURING THE
SECOND YEAR. ALL 20 DECIDUOUS TEETH ARE GENERALLY PRESENT BY 2.5 TO 3 YEARS OF
AGE
RLE 107
Growth and Development: Toddler and Preschooler
DEVELOPMENTAL MILESTONE
RLE 107
Growth and Development: Toddler and Preschooler
RLE 107
Growth and Development: Toddler and Preschooler
TODDLER NUTRITION
➢
➢
➢
➢
Sedentary children ages 1 to 3 years should consume 1000 kcal daily
Active children in this age group may need up to 1400 kcal daily
Calories are best supplied by a variety of foods spaced into three meals a day
Protein and carbohydrate needs are often those most easily met during the toddler
period
➢ Diets high in sugar should be avoided.
RLE 107
Growth and Development: Toddler and Preschooler
➢ Adequate calcium and phosphorus intake are important for bone mineralization.
➢ Milk should be whole milk until age 2 years
PROMOTING TODDLER DEVELOPMENT IN DAILY ACTIVITIES
A TODDLER’S NEW INDEPENDENCE AND DEVELOPING ABILITIES IN SELF -CARE, SUCH AS
DRESSING, EATING, AND, TO A LIMITED EXTENT, HYGIENE, PRESENT SPECIAL CHALLENGES FOR
PARENTS. LEARNING HOW TO PROMOTE AUTONOMY YET MAINTAIN A SAFE, HEALTHFUL
ENVIRONMENT SHOULD BE A MAJOR GOAL FOR THE FAMILY.
DRESSING
o
By the end of the toddler period, most children can put on their own socks, underpants, and
undershirt (Fig. 30.6). Some may also be able to pull on slacks, pullover shirts (the sleeves of a shirt
often confuse a toddler), or simple dresses.
SLEEP
o
The amount of sleep children need gradually decreases as they grow older (Goldson & Reynolds,
2008). They may begin the toddler period napping twice a day and sleeping 12 hours each night, and
end it with one nap a day and only 8 hours’ sleep at night.
BATHING
o
Toddlers usually enjoy bath time, and parents should make an effort to make it fun by providing a
toy, such as a rubber duck, boat, or plastic fish. Bath time is usually so enjoyable for toddlers that
parents can use it as a recreational activity or something to do on a rainy day when they can find
nothing else to interest their child.
CARE OF TEETH
o
o
Toddlers need to have a toothbrush they recognize as their own.
Toddlers often need between-meal snacks. Encourage parents to offer fruit (bananas, pieces of
apple, orange slices) or protein foods (cheese or pieces of chicken) rather than high carbohydrate
items for snacks such as cookies not only for the nutrition involved but also because protein snacks
help prevent caries more than sugar snacks by limiting exposure of the child’s teeth to carbohydrate.
Calcium (found in large amounts in milk, cheese, and yogurt) is especially important to the
development of strong teeth and are good for snacks
TOILET TRAINING
o
o
Toilet training is an individualized task for each child.
Toilet training is one of the biggest tasks a toddler tries to achieve.
RLE 107
Growth and Development: Toddler and Preschooler
Before children can begin toilet training, they must have reached three important developmental
levels, one physiologic and the other two cognitive:
1. They must have control of rectal and urethral sphincters, usually achieved at the time they walk
well.
2. They must have a cognitive understanding of what it means to hold urine and stools until they
can release them at a certain place and time.
3. They must have a desire to delay immediate gratification for a more socially accepted action.
RITUALISTIC BEHAVIOR
o
o
o
Toddlers enjoy ritualistic patterns
They will use only “their” spoon at mealtime, only “their” washcloth at bath time.
They will not go outside unless mother or father locates their favorite cap.
NEGATIVISM
o
o
o
Toddlers reply to every request is a very definite “NO.”
As part of establishing their identities as separate individuals, toddlers typically go through a period
of extreme negativism.
They do not want to do anything a parent wants them to do
DISCIPLINE
o
o
o
“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 of the rules that were learned.
SEPARATION ANXIETY
o
Fear of being separated from parents begins at about 6 months of age and persists throughout the
preschool period.
RLE 107
Growth and Development: Toddler and Preschooler
TEMPER TANTRUMS
➢
THE CHILD MAY KICK, SCREAM, STAMP FEET, SHOUT “NO, NO, NO,” LIE ON THE FLOOR,
FLAIL ARMS AND LEGS, AND BANG THE HEAD AGAINST THE FLOOR.
➢
CHILDREN MAY EVEN HOLD THEIR BREATH UNTIL THEY BECOME CYANOTIC.
➢
IF BREATH HOLDING, THE CHILD DEVELOPS A DISTENDED CHEST (A HALT AFTER
INSPIRATION), OFTEN AIR-FILLED CHEEKS, AND INCREASING DISTRESS AS THE CHILD’S
BODY REGISTERS OXYGEN WANT.
➢
THEY OCCUR BECAUSE TODDLERS ARE INDEPENDENT ENOUGH TO KNOW WHAT THEY
WANT, BUT THEY DO NOT HAVE THE VOCABULARY OR THE WISDOM TO EXPRESS.
RLE 107
Growth and Development: Toddler and Preschooler
RLE 107
Growth and Development: Toddler and Preschooler
KEY POINTS
➢
ERIKSON’S DEVELOPMENTAL TASK FOR THE TODDLER PERIOD IS TO FORM A SENSE OF
AUTONOMY OR INDEPENDENCE VERSUS SHAME OR DOUBT.
➢
TODDLERS MAKE GREAT STRIDES FORWARD IN DEVELOPMENT, BUT THEIR PHYSICAL
GROWTH SLOWS.
➢
A CRITICAL MILESTONE OF TODDLER DEVELOPMENT IS BEING ABLE TO FORM TWO WORD SENTENCES (A NOUN AND A VERB) BY 2 YEARS OF AGE.
➢
TODDLERS ARE CAPABLE OF PREOPERATIONAL THOUGHT OR ARE ABLE TO DEAL
MUCH MORE CONSTRUCTIVELY WITH SYMBOLS THAN THEY COULD WHILE INFANTS.
➢
IMPORTANT ASPECTS OF CARE ARE PROMOTING TODDLER SAFETY, INCLUDING
SCREENING FOR LEAD POISONING; PROMOTING TODDLER DEVELOPMENT, SUCH AS
PROMOTING DAILY ACTIVITIES; AND HEALTHY FAMILY FUNCTIONING.
➢
TODDLER APPETITES DECREASE FROM THOSE OF THE INFANT, SO CHILDREN EAT
PROPORTIONALLY LESS THAN THEY DID AS INFANTS.
➢
COMMON CONCERNS OF PARENTS DURING THE TODDLER PERIOD ARE TOILET
TRAINING, RITUALISTIC BEHAVIOR, NEGATIVISM, TEMPER TANTRUMS, DISCIPLINE,
AND SEPARATION ANXIETY.
➢
PROMOTING AUTONOMY IN THE CHILD WHO IS PHYSICALLY CHALLENGED OR
CHRONICALLY ILL CALLS FOR CREATIVE PLANNING, BECAUSE THERE MAY BE MANY
TASKS THAT MUST BE DONE FOR THE CHILD TO BE CERTAIN THEY ARE DONE SAFELY.
RLE 107
Growth and Development: Toddler and Preschooler
PRESCHOOLER
AGE: 3 – 6 YEARS OLD
PHYSICAL GROWTH SLOWS CONSIDERABLY DURING THIS PERIOD.
PERSONALITY AND COGNITIVE GROWTH CONTINUE AT A RAPID RATE.
MOST CHILDREN OF THIS AGE WANT TO DO THINGS FOR THEMSELVES —CHOOSE THEIR
OWN CLOTHING AND DRESS BY THEMSELVES, FEED THEMSELVES COMPLETELY, WASH
THEIR OWN HAIR, AND SO FORTH.
PARENTS
Parents of a preschooler may find their child dressed in one red sock and one green sock, going to
preschool with unwashed ears, or trying to eat soup with a fork. They need reassurance that this
behavior is typical as it is the way that children adjust to new experiences. Parents may also need
some guidance in separating those tasks a preschooler can accomplish independently from those
that still require some adult supervision so they can set sensible limits.
PHYSICAL GROWTH
A DEFINITE CHANGE IN BODY CONTOUR OCCURS DURING THE PRESCHOOL YEARS. THE
WIDE-LEGGED GAIT, PROMINENT LORDOSIS, AND PROTUBERANT ABDOMEN OF THE
TODDLER CHANGE TO SLIMMER, TALLER, AND MUCH MORE CHILDLIKE PROPORTIONS.
ECTOMORPHIC (SLIM) OR ENDOMORPHIC (LARGE)
RLE 107
Growth and Development: Toddler and Preschooler
WEIGHT, HEIGHT, AND HEAD CIRCUMFERENCE
➢
WEIGHT GAIN IS SLIGHT DURING THE PRESCHOOL YEARS
➢
APPETITE REMAINS AS IT WAS DURING THE TODDLER YEARS, WHICH IS
CONSIDERABLY LESS THAN SOME PARENTS WOULD LIKE OR EXPECT.
➢
THE AVERAGE CHILD GAINS ONLY ABOUT 4.5 LB (2 KG) A YEAR.
➢
HEIGHT GAIN IS ALSO MINIMAL DURING THIS PERIOD: ONLY 2 TO 3.5 IN (6 TO 8 CM) A
YEAR ON AVERAGE
TEETH
CHILDREN GENERALLY HAVE ALL 20 OF THEIR DECIDUOUS TEETH BY 3 YEARS OF AGE.
RLE 107
Growth and Development: Toddler and Preschooler
BODY SYSTEMS
ANTIBODIES - LYMPHATIC TISSUE BEGINS TO INCREASE IN SIZE, PARTICULARLY THE
TONSILS, AND LEVELS OF IGG AND IGA ANTIBODIES INCREASE.
HEART - HEART SOUNDS MAY BE PRESENT FOR THE FIRST TIME ON AUSCULTATION;
INNOCENT HEART MURMURS MAY ALSO BE HEARD FOR THE FIRST TIME.
PULSE RATE - DECREASES TO ABOUT 85 BEATS PER MINUTE
BLOOD PRESSURE - HOLDS AT ABOUT 100/60 MM HG
BLADDER - EASILY PALPABLE ABOVE THE SYMPHYSIS PUBIS, VOIDING IS FREQUENT
ENOUGH (9 OR 10 TIMES A DAY)
MUSCLES - NOTICEABLY STRONGER AND MAKE ACTIVITIES SUCH AS GYMNASTICS
POSSIBLE
DEVELOPMENTAL MILESTONE
DEVELOPMENTAL TASK: INITIATIVE VERSUS GUILT
➢ THE DEVELOPMENTAL TASK OF THE PRESCHOOL YEARS, ACCORDING TO ERIKSON,
IS TO FORM A SENSE OF INITIATIVE VERSUS GUILT (ERIKSON, 1993).
➢ A CHILD WITH A WELL-DEVELOPED SENSE OF INITIATIVE HAS DISCOVERED THAT
LEARNING NEW THINGS IS FUN.
➢ IF CHILDREN ARE CRITICIZED OR PUNISHED FOR ATTEMPTS AT INITIATIVE, THEY
DEVELOP A SENSE OF GUILT FOR WANTING TO TRY NEW ACTIVITIES OR HAVE NEW
EXPERIENCES.
RLE 107
Growth and Development: Toddler and Preschooler
➢ TO GAIN A SENSE OF INITIATIVE, PRESCHOOLERS NEED EXPOSURE TO A WIDE
VARIETY OF EXPERIENCES AND PLAY MATERIALS SO THEY CAN LEARN AS MUCH
ABOUT THE WORLD AS POSSIBLE.
THEY ARE READY TO REACH OUTSIDE THEIR HOMES FOR NEW EXPERIENCES, SUCH AS A
TRIP TO THE ZOO OR AN AMUSEMENT PARK.
THEY ARE INTERESTED IN SEEING NEW PLACES, AND SO ENJOY GOING WITH THE FAMILY
ON VACATION.
IMITATION
➢ Preschoolers need free rein to imitate the roles of the people around them.
➢ Role playing should be fun and does not have to be accurate.
➢ Children generally imitate those activities best that they see their parents performing at home.
FANTASY
➢ Toddlers cannot differentiate between fantasy and reality; they believe cartoon characters or
children in books are real
➢ Preschoolers begin to make this differentiation.
➢ Such intense involvement in play is part of “magical thinking,” or believing thoughts and wishes can
come true
OEDIPUS AND ELECTRA COMPLEXES
OEDIPUS COMPLEX refers to the strong emotional attachment a preschool boy
demonstrates toward his mother
ELECTRA COMPLEX is the attachment of a preschool girl to her father
GENDER ROLES
➢ Preschoolers need exposure to an adult of the opposite gender so they can become familiar with
opposite gender roles.
➢ Children’s gender-typical actions are strengthened by parents, strangers, preschool teachers, other
family members, and other children.
SOCIALIZATION
3 years old - capable of sharing, they play with other children their age much more
agreeably than do toddlers, which is why the preschool period is a sensitive and critical
time for socialization.
RLE 107
Growth and Development: Toddler and Preschooler
4 YEARS OLD - continue to enjoy play groups, they may become involved in arguments
more than they did at age 3, especially as they become more certain of their role in the
group.
5 YEARS OLD - begin to develop “best” friendships, perhaps on the basis of who they walk
to school with or who lives closest to them.
COGNITIVE DEVELOPMENT
➢ At age 3 years, cognitive development according to Piaget is still preoperational
(Piaget, 1969).
➢ Second phase called intuitional thought, they lack the insight to view themselves
as others see them or put themselves in another’s place (termed centering)
➢ They feel they are always right.
➢ Preschoolers are not yet aware of the property of conservation
➢ They cannot see that only the form, not the amount, has changed.
MORAL AND SPIRITUAL DEVELOPMENT
➢ Children of preschool age determine right from wrong based on their parents’ rules.
➢ They have little understanding of the rationale for these rules or even whether the
rules are consistent.
➢ Preschoolers begin to have an elemental concept of God if they have been provided
some form of religious training.
RLE 107
Growth and Development: Toddler and Preschooler
PROMOTING PRESCHOOLER SAFET
PROMOTING DEVELOPMENT OF THE PRESCHOOLER IN DAILY ACTIVITIES
The preschooler has often mastered the basic skills needed for most self -care activities,
including feeding, dressing, washing (with supervision), and brushing teeth (again, with
supervision).
RLE 107
Growth and Development: Toddler and Preschooler
DRESSING
O
O
Many 3-year-olds and most 4-year-olds can dress themselves except for difficult buttons, although
there may be a conflict over what a child will wear.
Preschoolers prefer bright colors or prints and so may select items that do not match.
SLEEP
O
O
More aware of their needs; when they are tired, they often curl up on a couch or soft chair and fall
asleep
Children in this age group, however, may refuse to go to sleep because of fear of the dark. Night
waking from nightmares or night terrors reaches its peak
EXERCISE
O
O
The preschool period is an active phase, so children receive a great deal of exercise.
Promoting active game and reducing television watching can help children develop motor skills as
well as be a step toward preventing childhood obesity (Kline, 2008).
HYGIENE
o
o
o
o
o
o
Preschoolers can wash and dry their hands adequately if the faucet is regulated for them so they do
not scald themselves with hot water.
Preschoolers do not clean their fingernails very well, so these often need “touching up” by a parent
or older sibling.
The child may also need the assistance of a parent or older sibling to clean the ears during bath time.
Hair washing can be a problem, as well.
If independent toothbrushing was not started as a daily practice during the infant or toddler years,
it should be started during the preschool years.
Night Grinding. Bruxism - may be a way of “letting go,” similar to body rocking, that children do for
a short time each night to release tension and allow themselves to fall asleep. Children who grind
their teeth extensively may have greater-than-average anxiety.
DISCIPLINE
O
O
O
Preschoolers have definite opinions on things such as what they want to eat, where they want to go,
and what they want to wear. T
This may bring them into opposition with parents. A major parental responsibility when this happens
is to guide a child through these struggles without discouraging the child’s right to have an opinion.
“Timeout” is a good technique to correct behavior for parents throughout the preschool year.
COMMON FEARS OF THE PRESCHOOLER.
O
FEAR OF THE DARK. The tendency to fear the dark is an example of a fear heightened by a child’s
vivid imagination: a stuffed toy by daylight becomes a threatening monster at night.
O
FEAR OF MUTILATION. Fear of mutilation is also significant during the preschool age, as revealed
by the intense reaction of a preschooler to even a simple injury such as falling and scraping a knee or
having a needle inserted for an immunization.
RLE 107
Growth and Development: Toddler and Preschooler
O
FEAR OF SEPARATION OR ABANDONMENT. Fear of separation continues to be a major concern
for preschoolers. For some children, it intensifies because their keen imagination allows them to
believe they have been deserted when they are safe.
BEHAVIOR VARIATIONS
A COMBINATION OF A KEEN IMAGINATION AND IMMATURE REASONING RESULTS IN COMMON
BEHAVIOR VARIATIONS IN PRESCHOOLERS.
TELLING TALL TALES. STRETCHING STORIES TO MAKE THEM SEEM MORE
INTERESTING IS A PHENOMENON FREQUENTLY ENCOUNTERED IN THIS AGE GROUP.
IMAGINARY FRIENDS. MANY PRESCHOOLERS HAVE AN IMAGINARY FRIEND WHO
PLAYS WITH THEM (GOLDSON & REYNOLDS, 2008).
DIFFICULTY SHARING. SHARING IS A CONCEPT THAT FIRST COMES TO BE
UNDERSTOOD AROUND THE AGE OF 3 YEARS.
REGRESSION. SOME PRESCHOOLERS, GENERALLY IN RELATION TO STRESS, REVERT
TO BEHAVIOR THEY PREVIOUSLY OUTGREW, SUCH AS THUMBSUCKING, NEGATIVISM,
LOSS OF BLADDER CONTROL, AND INABILITY TO SEPARATE FROM THEIR PARENTS.
SIBLING RIVALRY. JEALOUSY OF A BROTHER OR SISTER MAY FIRST BECOME EVIDENT
DURING THE PRESCHOOL PERIOD (TAYLOR, 2007). THIS OCCURS PARTLY BECAUSE
THIS IS THE FIRST TIME THAT CHILDREN HAVE ENOUGH VOCABULARY TO EXPRESS
HOW THEY FEEL (KNOW A NAME TO CALL) AND PARTLY BECAUSE P RESCHOOLERS ARE
MORE AWARE OF FAMILY ROLES AND HOW RESPONSIBILITIES AT HOME ARE DIVIDED.
KEY POINTS
➢
ALTHOUGH PRESCHOOLERS GROW ONLY SLIGHTLY AND GAIN JUST A LITTLE WEIGHT,
THEY SEEM MUCH TALLER THAN WHEN THEY WERE TODDLERS BECAUSE THEIR
CONTOUR CHANGES TO MORE CHILDLIKE PROPORTIONS.
➢
ERIKSON’S DEVELOPMENTAL TASK FOR THE PRESCHOOL PERIOD IS TO GAIN A SENSE OF
INITIATIVE OR LEARN HOW TO DO THINGS. PLAY MATERIALS
➢
IDEAL FOR THIS AGE GROUP ARE THOSE THAT STIMULATE CREATIVITY, SUCH AS
MODELING CLAY OR COLORED MARKERS.
➢
PROMOTING CHILDHOOD SAFETY IS A MAJOR ROLE BECAUSE PRESCHOOLERS’ ACTIVE
IMAGINATIONS CAN LEAD THEM INTO DANGEROUS SITUATIONS.
RLE 107
Growth and Development: Toddler and Preschooler
➢
APPETITE IS NOT LARGE IN THIS AGE GROUP BECAUSE THIS IS NOT A RAPID GROWTH
TIME. PRESCHOOLERS CAN BE INTERESTED IN HELPING WITH FOOD PREPARATION.
➢
COMMON PARENTAL CONCERNS DURING THE PRESCHOOL PERIOD ARE BROKEN
FLUENCY, IMAGINARY FRIENDS, DIFFICULTY SHARING, AND SIBLING RIVALRY.
➢
PRESCHOOL IS OFTEN THE TIME WHEN A NEW SIBLING IS BORN. GOOD PREPARATION
FOR THIS IS NECESSARY TO PREVENT INTENSE SIBLING RIVALRY.
➢
PRESCHOOLERS HAVE A NUMBER OF UNIVERSAL FEARS, INCLUDING FEAR OF THE DARK,
MUTILATION, AND ABANDONMENT. ALL CARE PROVIDED FOR THIS AGE GROUP SHOULD
INCLUDE ACTIVE MEASURES TO REDUCE THESE FEARS AS MUCH AS POSSIBLE.
➢
PRESCHOOLERS ARE STILL OPERATING AT A COGNITIVE LEVEL THAT PREVENTS THEM
FROM UNDERSTANDING CONSERVATION (OBJECTS HAVE NOT CHANGED SUBSTANCE
ALTHOUGH THEY HAVE CHANGED APPEARANCE). THIS MEANS THEY NEED AN
EXPLANATION, FOR EXAMPLE, OF HOW THEY WILL BE THE S AME PERSON
POSTOPERATIVELY AS THEY WERE PREOPERATIVELY.
➢
PRESCHOOLERS ARE SELF-CENTERED (EGOCENTRIC). THIS MAKES IT DIFFICULT FOR
THEM TO SHARE AND VIEW SOMEONE ELSE’S SIDE OF A PROBLEM. THEY NEED GOOD
EXPLANATIONS OF HOW A PROCEDURE WILL BENEFIT THEM BEFORE THEY CAN AGREE
TO IT.
➢
MANY PRESCHOOLERS BEGIN PRESCHOOL PROGRAMS OR CHILD CARE. LATE IN THE
PRESCHOOL PERIOD, THEY MAY BE ENROLLED IN KINDERGARTEN. PARENTS OFTEN
APPRECIATE GUIDANCE ON HOW TO PREPARE THEIR CHILDREN FOR THESE NEW
EXPERIENCES.
➢
PRESCHOOLERS WHO ARE PHYSICALLY CHALLENGED OR WHO HAVE CHRONIC ILLNESSES
MAY HAVE DIFFICULTY ACHIEVING A SENSE OF INITIATIVE, BECAUSE THEY MAY BE
LIMITED IN THEIR ABILITY TO PARTICIPATE IN ACTIVITIES THAT STIMULATE INITIATIVE.
THEY MAY NEED SPECIAL PLAYTIMES SET ASIDE FOR STIMULATION AND LEARNING.
APPLICATION
TASK TO ACCOMPLISH
CHILDREN WHO ARE HOSPITALIZED FOR LONG PERIODS MAY FALL BEHIND IN DEVELOPMENT.
WHAT SPECIFIC MEASURES COULD YOU TAKE TO PROMOTE DEVELOPMENTAL GROWTH AND
ENCOURAGE A SENSE OF AUTONOMY IF JOHN WERE A HOSPITALIZED 2 -YEAR-OLD? TO PROMOTE
A SENSE OF INITIATIVE IF HE WERE HOSPITALIZED AT AGE 5 YEARS?
RLE 107
Growth and Development: Toddler and Preschooler
ASSESSMENT
TRUE OR FALSE: WRITE THE WORD TRUE IF THE STATEMENT IS CORRECT AND WRITE THE WORD
FALSE IF OTHERWISE.
_______1. 17 MONTH-OLD TODDLER CAN STACK 2 BLOCKS AND CAN UTTER 4-6 WORDS.
_______2. TODDLERS DO NOT ENJOY RITUALISTIC PATTERNS
_______3. PUNISHMENT IS A CONSEQUENCE THAT RESULTS FROM A BREAKDOWN IN DISCIPLINE
_______4. TODDLER STAGE IS ON ANAL STAGE
_______5. SEPARATION ANXIETY BEGINS AT 4 MONTHS
_______6. PRESCHOOLER’S PERSONALITY AND COGNITIVE GROWTH HAMPERS DOWN.
_______7. THE DEVELOPMENTAL TASK OF THE PRESCHOOL YEARS, ACCORDING TO PIAGET, IS TO
FORM A SENSE OF INITIATIVE VERSUS GUILT.
_______8. ROLE PLAYING SHOULD BE FUN AND DOES NOT HAVE TO BE ACCURATE.
_______9. ELECTRA COMPLEX REFERS TO THE STRONG EMOTIONAL ATTACHMENT A PRESCHOOL
BOY DEMONSTRATES TOWARD HIS MOTHER
_______10. MANY PRESCHOOLERS HAVE AN IMAGINARY FRIEND WHO PLAYS WITH THEM
SYNTHESIS
KNOWLEDGE OF GROWTH AND DEVELOPMENT IS IMPORTANT IN HEALTH PROMOTION AND
ILLNESS PREVENTION BECAUSE IT LAYS THE BASIS FOR ASSESSMENT AND ANTICIPATORY
GUIDANCE. GENETIC FACTORS THAT INFLUENCE GROWTH AND DEVELOPMENT ARE GENDER,
ETHNICITY, INTELLIGENCE, AND HEALTH. ENVIRONMENTAL INFLUENCES INCLUDE QUALITY OF
NUTRITION, SOCIOECONOMIC LEVEL, PARENT –CHILD RELATIONSHIP, ORDINAL POSITION IN THE
FAMILY, AND ENVIRONMENTAL HEALTH. TO MEET GROWTH AND DEVELOPMENT MILESTONES,
CHILDREN NEED TO FOLLOW BASIC GUIDELINES FO R A HEALTHY DIET, SUCH AS EATING A
VARIETY OF FOODS; MAINTAINING IDEAL WEIGHT; AVOIDING EXTREME LEVELS OF SATURATED
FAT AND CHOLESTEROL; EATING FOODS WITH ADEQUATE STARCH AND FIBER; AND AVOIDING
TOO MUCH SUGAR, THE SAME AS ADULTS. TEMPERAMENT IS A CHILD’S CHARACTERISTIC
MANNER OF THINKING, BEHAVING, OR REACTING. HELPING PARENTS UNDERSTAND THE EFFECT
OF TEMPERAMENT IS A NURSING ROLE. COMMON THEORIES OF DEVELOPMENT ARE FREUD’S
PSYCHOANALYTIC THEORY AND ERIKSON’S THEORY OF PSYCHOSOCIAL DEVELOPMENT. BOTH
OF THESE THEORIES DESCRIBE SPECIFIC TASKS CHILDREN MUST COMPLETE AT EACH STAGE OF
DEVELOPMENT TO BECOME A WELL -ADAPTED ADULT. PIAGET’S THEORY OF COGNITIVE
DEVELOPMENT DESCRIBES WAYS THAT CHILDREN LEARN. KOHLBERG ADVANCED A THEORY OF
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MORAL DEVELOPMENT, OR HOW CHILDREN USE MORAL REASONING TO SOLVE PROBLEMS THEY
FACE. ALTHOUGH GROWTH AND DEVELOPMENT OCCUR IN KNOWN PATTERNS, THEIR RATE
VARIES FROM CHILD TO CHILD. CAUTION PARENTS NOT TO BE CONCERNED BECAUSE TWO
SIBLINGS ARE VERY DIFFERENT AS LONG AS THEY BOTH FIT WITHIN USUAL PARAMETERS.
SELF-REFLECTION
MARK 10:13-16
“AND THEY WERE BRINGING CHILDREN TO HIM THAT HE MIGHT TOUCH THEM, AND THE
DISCIPLES REBUKED THEM. BUT WHEN JESUS SAW IT, HE WAS INDIGNANT AND SAID TO
THEM, “LET THE CHILDREN COME TO ME; DO NOT HINDER THEM, FOR TO SUCH BELONGS
THE KINGDOM OF GOD. TRULY, I S AY TO YOU, WHOEVER DOES NOT RECEIVE THE
KINGDOM OF GOD LIKE A CHILD SHALL NOT ENTER IT.” AND HE TOOK THEM IN HIS ARMS
AND BLESSED THEM, LAYING HIS HANDS ON THEM.”
FROM WHAT YOU HAVE LEARNED FROM LESSON 1, MAKE A SHORT REFLECTION
ABOUT THE TOPIC.
REFERENCES:
Pillitteri, Adele. Maternal and Child Health Nursing: Care of the Childbearing and Childrearing
Family/Adele Pillitteri.—6th ed .
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