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Toddler and Preschooler Module
Toddler and Preschooler Module
Growth and
Development
INTRODUCTION
NCM 107
Growth and Development: Toddler and Preschooler
TODDLER
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 SUPPORT THEIR CHILD’S GROWING
INDEPENDENCE WITH PATIENCE AND SENSITIVITY AND TO LEARN METHODS FOR
HANDLING THE CHILD’S FRUSTRATIONS THAT ARISE F ROM THE QUEST FOR
AUTONOMY
NCM 107
Growth and Development: Toddler and Preschooler
PHYSICAL GROWTH
While toddlers are making great strides developmentally, their physical growth begins
to slow.
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 equ als chest circumference at 6 months
to 1 year of age.
By 2 years, chest circumference has grown greater than that of the head.
NCM 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
NCM 107
Growth and Development: Toddler and Preschooler
BODY SYSTEMS
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 T O 3 YEARS OF
AGE
NCM 107
Growth and Development: Toddler and Preschooler
DEVELOPMENTAL MILESTONE
NCM 107
Growth and Development: Toddler and Preschooler
NCM 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.
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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
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 Toddlers need to have a toothbrush they recognize as their own.
o 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 Toilet training is an individualized task for each child.
o Toilet training is one of the biggest tasks a toddler tries to achieve.
NCM 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 Toddlers enjoy ritualistic patterns
o They will use only “their” spoon at mealtime, only “their” washcloth at bath time.
o They will not go outside unless mother or father locates their favorite cap.
NEGATIVISM
o Toddlers reply to every request is a very definite “NO.”
o As part of establishing their identities as separate individuals, toddlers typically go through a period
of extreme negativism.
o They do not want to do anything a parent wants them to do
DISCIPLINE
o “DISCIPLINE” AND “PUNISHMENT” are not interchangeable terms.
o Discipline means setting rules or road signs so children know what is expected of them.
o 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.
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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.
➢ THEY OCCUR BECAUSE TODDLERS ARE INDEPENDENT ENOUGH TO KNOW WHAT THEY
WANT, BUT THEY DO NOT HAVE THE VOCABULAR Y OR THE WISDOM TO EXPRESS.
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Growth and Development: Toddler and Preschooler
NCM 107
Growth and Development: Toddler and Preschooler
KEY POINTS
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Growth and Development: Toddler and Preschooler
PRESCHOOLER
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.
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Growth and Development: Toddler and Preschooler
WEIGHT, HEIGHT, AND HEAD CIRCUMFERENCE
➢ HEIGHT GAIN IS ALSO MINIMAL DURING T HIS PERIOD: ONLY 2 TO 3.5 IN (6 TO 8 CM) A
YEAR ON AVERAGE
TEETH
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Growth and Development: Toddler and Preschooler
BODY SYSTEMS
HEART - HEART SOUNDS MAY BE PRESENT FOR THE FIRST TIME ON AUSCULTATION;
INNOCENT HEART MURMURS MAY ALSO BE HEARD FOR THE FIRST TIME.
DEVELOPMENTAL MILESTONE
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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 LEA RN 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
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.
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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
➢ 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 cannot see that only the form, not the amount, has changed.
➢ 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 the y have been provided
some form of religious training.
NCM 107
Growth and Development: Toddler and Preschooler
PROMOTING PRESCHOOLER SAFET
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).
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Growth and Development: Toddler and Preschooler
DRESSING
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.
O Preschoolers prefer bright colors or prints and so may select items that do not match.
SLEEP
O More aware of their needs; when they are tired, they often curl up on a couch or soft chair and fall
asleep
O 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 The preschool period is an active phase, so children receive a great deal of exercise.
O 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 Preschoolers can wash and dry their hands adequately if the faucet is regulated for them so they do
not scald themselves with hot water.
o Preschoolers do not clean their fingernails very well, so these often need “touching up” by a parent
or older sibling.
o The child may also need the assistance of a parent or older sibling to clean the ears during bath time.
o Hair washing can be a problem, as well.
o If independent toothbrushing was not started as a daily practice during the infant or toddler years,
it should be started during the preschool years.
o 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 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
O 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.
O “Timeout” is a good technique to correct behavior for parents throughout the preschool year.
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.
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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
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.
➢ IDEAL FOR THIS AGE GROUP ARE THOSE THAT STIMULATE CREATIVITY, SUCH AS
MODELING CLAY OR COLORED MAR KERS.
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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.
➢ PRESCHOOL IS OFTEN THE TIME WHEN A NEW SIBLING IS BORN. GOOD PREPARATION
FOR THIS IS NECESSARY TO PREVENT INTENSE SIBLING RIVALRY.
SYNTHESIS
NCM 107
Growth and Development: Toddler and Preschooler
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 SPE CIFIC 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
MORAL DEVELOPMENT, OR HOW CHILDREN USE MORAL REASONIN G 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.
PURPOSIVE ASSIGNMENT:
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 .
NCM 107
Growth and Development: Toddler and Preschooler