DEVELOPMENTAL MILESTONES
SOCIALIZATION AND PLAY
 The toddler's "work"; language of the child
 Parallel play- children play among other
children, often with the same types of toys
 Children use their toys to play out what they
want and how they want things to be
 Play among others in an independent fashion
 Games: likes throwing and retrieving games;
selfish, possessive of toys
 Lack of interest in toys: danger sign
 Predominantly- “parallel play” period
 Provide toys appropriate for increased
locomotive skills: push toys, rocking horse,
riding toys or tricycles; swings and slide
 Give toys to provide outlet for aggressive
feelings: work bench, toy hammer and nails,
drums, pots, pans
 Provide toys to help develop fine motor skills,
problem-solving abilities: puzzles, blocks; finger
paints, crayons
PURPOSES OF PLAY
 Physical development
 Social development
 Therapeutic value
 Educational
 Moral values formation
CHARACTERISTICS OF PLAY
 Free, spontaneous, active, no rules
 Constructive
SELECTION OF PLAY MATERIALS
 Based on likes/dislikes
 No sharp edges
TOYS
 Push and pull toys
 Cars and trucks
 Balls
 Building blocks
 Stuff toys and dolls (security objects)
 Play telephone (this is a stage of training)
 Play hammer, drums, pots and pans (an outlet
of aggressive behavior)
 Wood simple puzzles
 Large crayons (can draw a circle at 3 years)
TODDLER
 The age from 1-3 years old
 Enormous changes take place in the child and in
the family
 The largely immobile and preverbal child now
becomes a walking, talking child with a sense of
independence.
 The term terrible twos has often been used to
describe the toddler years.
 It is a time of intense exploration of the
environment as children attempt to find out
how things work;
 What the word “no” means;
 The power of temper tantrums, negativism, and
obstinacy.
 “getting into things” is their way of learning
about their world, especially relationships.
 Successful mastery of the tasks requires a
strong foundation of trust during infancy and
frequently necessitates guidance from others
when parent and toddler face the struggles of
toilet training, limit setting, and sibling rivalry.
GROWTH AND DEVELOPMENT
A. Physical growth
B. Psychosexual development
C. Psycho-social development
D. Cognitive development
E. Moral development
F. Spiritual development
PHYSICAL GROWTH - begins to slow through the
toddler makes great strides developmentally.
 WEIGHT
─ Gains only about 5-6 lbs. (2.5 kg)
─ Quadrupled his birth weight
─ Decreased weight gains due to increased activity.
 HEIGHT
─ Gains on 5 inches (12cm) a year during toddler
period
─ Subcutaneous fat ("baby fat") begins to disappear
─ Estimate adult height: multiplying by 2 at 2 years
 HEAD
─ HC = CC at 6 months to 1 year
─ CC > HC at 2 years
─ Head circumference increases only about 2 cm
during the 2nd year compared to about 12 cm during
the 1st year
─ Anterior fontanel (bregma) closes at 12-18 months
 BODY CONTOUR
─ Prominent abdomen (LORDOSIS)
─ Waddle or walk with wide-stance
 BODY SYSTEM
RE SPIRATORY SYSTEM
─ Respiration slows slightly but remains to be
abdominal
─ The lumen of the tract increase progressively so
that the threat of lower respiratory infection is less
CARDIOVASCULAR SYSTEM
─ Heart slows from 110 to 90 bpm
─ Blood pressure increases to about 99/64 mmHg
NERVOUS SYSTEM
─ Brain develops to about 90% of adult size.
─ Complete myelination of spinal cord causes
urinary and anal sphincter control.
GI SYSTEM
─ Stomach capacity increases to the point that the
child can eat 3 meals a day
─ Stomach secretions become more acid → gi
infections are less common
IMMUNE SYSTEM
─ Igg and igm antibody production become mature
@ 2 years of age
─ The passive immunity effects from intrauterine life  Holding on and letting go are evident (toddler uses
are no longer operative the hands, mouth, eyes, and, eventually, sphincters
when toilet training is begun.)
DEFINITION
 Constantly express these social modalities in play
─ 8 new teeth activities such as casting or throwing objects;
─ The canines and the first molars erupt during the taking objects out of boxes, drawers, or cabinets;
2nd year holding on tighter when someone says, "No, don't
─ All 20 deciduous teeth are generally present by 2 touch"; and spitting out food as taste preferences
1/2 to 3 years at age become strong.
 Caloric requirement is approximately 100
Psychosocial Task
calories/kg/day
 Increased need for calcium, iron, and phosphorus  Increases independence - better able to tolerate
 Needs 16 - 24 oz milk/day separation from primary caregiver.
 Appetite decreases  Less likely to fear strangers.
 Able to feed self  Able to help with dressing/undressing at 18
 Negativism may interfere with eating months - dresses self at 24 months.
 Initial dental examination at 3 years  Has sustained attention span
 May have temper tantrums during this period;
PSYCHOSEXUAL DEVELOPMENT
should decrease by 2 1/2 years.
 Stage: ANAL STAGE - Child learns to control  Vocabulary increases from about 10 - 20 words to
urination and defecation over 900 words by 3 years.
 Nursing Implication: Help children achieve bowel  Has beginning awareness of ownership (my, mine)
and bladder control without undue emphasis on its at 18 months; shows proper use of pronouns (I,
importance. me, you) by 3 years
 As infants gain trust in the predictability and  Moves from hoarding and possessiveness at 18
reliability of their parents, environment, and months to sharing with peers by 3 years
interaction with others  TOILET TRAINING USING COMPLETED BY 3 YEARS.
 they begin to discover that their behavior is their ─ 18 months: bowel control
own and that it has a predictable, reliable effect on ─ 2 - 3 years: daytime bladder control
others. ─ 3 - 4 years: night time bladder control
 However, although they are aware of their will and  Differentiation of self from others, particularly the
control over others, they are confronted with the mother or primary caregiver
conflict of exerting autonomy and relinquishing the  Toleration of separation from parents
much-enjoyed dependence on others.  Ability to withstand delayed gratification
 Control over bodily functions
PSYCHOSOCIAL DEVELOPMENT  Acquisition of socially acceptable behavior
 Exerting their will has definite negative  Verbal means of communication
consequences, whereas retaining dependent,  Ability to interact with others in a less egocentric
submissive behavior is generally rewarded with manner
affection and approval. COGNITIVE DEVELOPMENT
 Continued dependency creates a sense of doubt
regarding their potential capacity to control their  Main cognitive achievement of early childhood:
actions compounded by a sense of shame for acquisition of language, which represents mental
feeling this urge to revolt against others' will and a symbolism.
fear that they will exceed their own capacity for  Inappropriate to expect toddlers to judge which
manipulating the environment receptacles are permissible to explore and which
 The latter fear is a basis for instituting limit setting are not.
and consistent discipline at this age.  Forbidden objects, such as the garbage pail, should
 Without appropriate limits on what is acceptable be placed out of reach.
versus unacceptable behavior, children have no
SENSORIMOTOR
guidelines for establishing the end points of their
STAGE COGNITIVE
ability to control. BEHAVIOR
AND AGE DEVELOPMENT
Understanding love for the child is shown by: Active
experimentation > Insatiable curiosity
─ Giving him all the freedom he can safely use to achieve about environment
Tertiary
─ Giving him all the love and help he needs to previously > Uses all sensory cues
Circular
keep him safe in an environment beyond his unattainable for exploration
Reactions
control goals
(13-18
─ Giving him guidance in avoiding hazards in the Increased Ventures away from
months)
changing social situation in which he feels concept of parent for longer
himself to be the focal point object periods
permanence
 Has the newly gained modality of holding on and
letting go.
 Differentiation  Uses “magical” thinking; believes own feelings
Uses physical skills to
of oneself from affect events (e.g., anger causes rain)
achieve particular goal
objects  Uses ritualistic behavior; repeats skills to master
Early traces of Can find hidden objects, them and to decrease anxiety
memory but only in first location  May develop dependency on “transitional object”
Able to insert round such as blanket or stuffed animal
Beginning
object into hole
awareness of
Fits smaller objects into CHARACTERISTICS OF PRE-OPERATIONAL THOUGHT
spatial, causal,
each other (nesting)
and temporal ─ Transductive - Reasoning from particular to
Gestures “up” and
relationships particular
“down”
> Puts objects into ─ Global Organization - Belief that changes from any
container and takes part of the whole changes the entire whole
Able to enter an them out ─ Centration - Focusing on one aspect rather than
action at any > Realizes that “out of considering all possible alternatives.
point without sight” is not out of ─ Animism - Attributing lifelike qualities to inanimate
reproducing reach; opens doors and objects
entire sequence drawers to find objects ─ Irreversibility - Inability to undo or reverse the
> Gains comfort from actions initiated physically
parent's voice even if ─ Magical Thinking - Believing that thoughts are all-
parent is not visible
powerful and cause events
Causal After flipping a light
─ Inability to Conserve - Inability to understand the
relationship switch, toddlers are
idea that a mass can be changed in size, shape,
between two aware that a reciprocal
events is response occurs but are volume, or length without losing or adding to the
apparent which not able to transfer that original mass (instead children judge what they see
demonstrates knowledge to new by the immediate perceptual clues given to them)
the beginning of situations. Therefore
categorizing every time they see  Concept of time is still embryonic, their sense of
data into what appears to be a timing is exaggerated-a minute can last an hour.
distinct classes, light switch, they must  limited attention spans also indicate their sense of
subclasses, and reinvestigate its immediacy and concern for the present
so on function.  Egocentrism, or the inability to envision situations
e.g. If the child's toys from perspectives other than one's own (e.g. A
are stored in a paper
toddler who takes a toy away from another child.
bag or large container,
The toddler is concerned only with playing with the
he or she does not
toy and is unable to conceptualize that taking the
Classification of perceive a difference
objects is still between that toy toy away will make the other child unhappy).
rudimentary, receptacle and the MORAL DEVELOPMENT
the appearance garbage pail or laundry
of an object basket. If allowed to PRE-CONVENTIONAL PHASE
denotes its turn over the toy
function. receptacle, the child will  involves punishment and obedience
just as quickly do the  Young children behave in accordance with the
same to other similar freedom or restriction that is placed on actions
objects because, in the  whether an action is good or bad depends on
child's mind, there is no whether it results in reward or punishment
difference.  If children are punished for it, the action is bad
Aware of space  If they are not punished, the action is good,
and the They will stretch, stand regardless of the meaning of the act
relationship of on a low stair or stool,
their body to and pull a string to SPIRITUAL DEVELOPMENT
dimensions such reach an object.)
 Toddlers learn about God through the words and
as height
COGNITIVE TASK the actions of those closest to them
 Have only a vague idea of God and religious
 Follows simple directions by 2 years. teachings because of their immature cognitive
 Begins to use short sentences at 18 months to 2 processes; however, if adults speak about God with
years. reverence, young children associate God with
 Can remember and repeat 3 numbers by 3 years. something special
 Knows own name by 12 months; refers to self,  Begin to assimilate behaviors associated with the
gives first name by 24 months; gives full name by 3 divine (folding hands in prayer)
years.  Routines such as saying prayers before meals or at
 Able to identify geometric forms by 18 months. bedtime can be important and comforting
 Achieves object permanence; is aware that objects
exist even if not in view