Growth and development of Toddler.pptx

growth and development of toddler

1. Growth & development of toddler Presented by - Swaraj Suman Msc Nursing 1 st year AIIMS BBSR

2. Toddler Toddler is of the developmental age group from 1 year to 3 years of age.

3. Growth & development of toddler Biological development Psychosocial development Psychosexual development Cognitive development Moral development Spiritual development

4. Contd.. Emotional development Language development

5. Biological development Proportional changes Weight - Average weight gain is 1.8-2.7 kg (4 -6 pounds) per year. Birth weight - Tripled - 1 year Of age - Quadrupled – 2 to 2 ½ years of age

6. Contd.. Height- 7.5 cm (3inches) per year Height of 2 years old child = 81-85 cm Expected height = age in years X 2 + 77 Length doubles by – 4 to 5 years of age Length is recorded for children <2 years of age = Infantometer > 2 years of age = Stadiometer

7. Contd.. Head circumference Total increase in HC in 2 year = 2.5cm (1 inch) Then rate of increase slows till 5 yrs. of age. 2 cm per month for first 3 months 1cm per month between 3 to 6 month 0.5 cm per month for the rest of first year of life Macrocephaly – defined as occipitofrontal circumference greater than 2 SD.( above the mean for age and sex). Microcephaly – defined as occipitofrontal circumference more than 3 SD.( below the mean for age, sex, and gestation ).

8. Contd. Chest circumference Continues to increases HC=CC? After 2 years CC > HC

9. Contd. MUAC It is used for the assessment of nutritional status. At birth 11 to 12 cm 1 yr. =12-16cm 1yr. to 5 yr. = 16-17cm

10. Wheech formula ( expected weight)

11. Calculation of percentages of malnutrition.(weight for age ) Formula= Acutal weight/ expected weight X 100 Eg :- 2 year of child having weight is 8 kg. 8/12 X100 = 66 % ( grade II malnutrition)

12. Dentition Age Type Total no. of teeth Temporary teeth 12-15 months First molars 8-12 15-24 months canines 12-16 24-30 months Second molars 16-20

13. Sensory changes Full binocular vision developed. Sense of hearing, smell, taste, and touch become increasingly well developed, coordinated with each other, & associated with experiences. Development of specific taste preferences.

14. Maturation of systems Integumentary system Resistance of skin to infections and ability to prevent fluid loss increased. Eccrine sweat glands produce small amounts of responses to warm temperature. Fine body hairs begin to grow on the arms and legs.

15. Contd.. Cardiovascular system Pulse , BP increases in toddler period. Blood vessels increases in size. Regulation of body temperature.

16. Contd.. Respiratory system Structures of respiratory tract increases in size with increase in thoracic volume and hence decrease in respiration rate .

17. Contd.. Gastrointestinal system Salivary glands reached maturity by the end of the 2 years of age. Capacity increases but rapidity of food passage through GI tract decreases. HCL production increases.

18. Contd. Genitourinary system Maturation of kidneys by 2 years of age. Myelination of urethral sphincter.

19. Contd.. Immune system Ig M reaches to adult level = 1 st yr. Of later life Ig G = middle of toddler period.

20. Contd.. Nervous system Brain reaches two third of its adult size at 2 years of age & three quarter by 3 years. Broca’s area developed. Motor control of extremities and sphincter. Myelination of spinal cord (able to stand , run, jump).

21. GROSS MOTOR At 15 months Assume standing position without help Walk without support

22. Contd.. Creeps up stairs Cannot throw ball without falling

23. Gross motor ( At 18 months) Child able to run Climbs on furniture Pull and pushes toys

24. Gross motor(At 24 months) Walk backward well Walks up & down stairs

25. Gross motor(30 months) Stand on one foot alone Walk up and down stairs

26. Rides a pedal car Can throw ball overhead

27. Gross motor Age Milestones 15 months Walks alone, creeps upstairs 18 months Runs , explores drawers 2 years Walk up and downstairs (2feet/ step) , jumps 3 years Rides tricycle , alternate foot going upstairs

28. Fine motor( At 15 months) Builds a tower of 2-3 cubes Open boxes Poking fingers in hole Scribble spontaneously

29. Fine motor( 18 months) Builds tower of 3- 4 cubes Imitates vertical lines Transfer object hand to hand at will

30. Contd … Walk on tip toe Jumps well in place with both feet

31. Fine motor (At 24 months) Builds a tower of 6-7 cubes Imitates horizontal lines Turns pages of book one at time

32. Fine motor (30 months) Makes horizontal & vertical lines( not able to join) Imitates circular strokes (good hand finger coordination). Holds crayon with fingers Builds tower of 8 cubes

33. Fine motor milestones Age Milestones 15 months Imitates scribbling, tower of 2 blocks 18 months Scribbles, tower of 3 blocks 2 years Towers of 6 blocks, vertical and circular strokes 3 years Towers of 9 blocks, copies circle

34. Towers of Cubes/ blocks= Age X 3 Eg :- Eg :- 2 X 3 =6 (2 year baby can make 6 towers of cubes) 3 X 3 = 9 ( 3 year baby can make 9 towers of cubes) age No of blocks 15 m 2cubes 18 m 3 cubes

35. 18 months 24 months ( 2 year) 3 year 4 year Drawing skill at various ages

36. At 15 months At 18 months-24 months 30 months Feeding skills Hold with two hands Manage spoon without rotation Frequently spillage Remove simple garments Ready for bowel and bladder control Verbalize toilet needs occasional spillage Dressing skills stick out arm and legs Buttons & unbuttons one large front button Toileting skills May complain when wet day time bladder control but beginning night time bladder control.

37. Language development At 15 months At 18 months At 2 years At 3 years Uses expressive jargon (4- 6 words) Asks objects by pointing Understands simple command May use head-shaking gestures Say 10 or more words Form word combinations Approximately 300 words. Use two or three word phrases. Uses I ,you Understand directions Asks questions. Knows name, age, sex

38. Emotional development Separation anxiety fear

39. Theories of development Psychosexual development - Anal stages

40. Psychosocial development Autonomy v/s shame, doubt

41. Cognitive development Sensorimotor (Birth to 2 years) Substage 5 ( 12 to 18 months)- tertiary circular reaction Substage 6 ( 18 months to 2 years)- The invention of new means through mental combinations. Preoperational stage (2 to 7 years) - The child begins to represent the world symbolically.

42. Moral development Pre conventional level- Stage 0 ( birth to 2 yrs.) – What I like is good. Stage 1 ( 2 yrs. to 3 yrs.) Punishment-obedience-orientation

43. Spiritual development Intuitive projective faith

44. Play Parallel play

45. Need of the toddler Around this age, the children will begin to understand the cause and effect of doing so. They are able to follow simple commands . They have specific likes and dislikes. In this state children need - P arental love Acceptance Proper nutrition Play stimulation Toilet training Immunization Safety Nutrition

46. Common injuries and Accidents in toddler

47. Journal review Journal of child & adolescent behavior Author:- Butchon and liabsuetrakul , year- 2017, 5:1 T he development and growth of children aged under 5 years in northeastern thailand : a cross-sectional study Methods : A cross-sectional survey was conducted in the northeast of thailand during april-september 2014.Seventy thai mothers aged less than 34 years who were admitted to the postpartum ward of a regional hospital and their first child were included. Developmental delay among their first children was assessed by the denver II, thai version. Results:- C hildren aged 36-62 months showed a higher delayed development, especially in the gross motor domain. The prevalence of underweight and stunting were common among children aged 12-35 months (6.2% and 15.6%, respectively) and wasting was higher among those aged 36-62 months (5.3%). Hyperactivity and showing anger when displeased were common. Conclusion: A high prevalence of suspected delay was found among children aged 36-62 months. Suboptimal growth was common among those 12-35 months. Early identification of developmental delay and early interventions may have a substantial impact on financial, educational, and social costs in the future.

48. Parent report measures of infant and toddler social-emotional development: a systematic review A uthor:- Maiken Pontoppidan (2017) Methods:  We conducted a systematic review applying a narrative synthesis approach. We searched Medline, PsychInfo , Embase for articles published from 2008 through September 2015 to identify parent-report measures of infant and toddler social-emotional development. Data on the characteristics of the measures, including psychometric data, were collected. Results:  Based on 3310 screened articles, we located 242 measures that were screened for eligibility. In all 18 measures of infant and toddler social-emotional development were included. Ten of the measures were developed specifically for measuring social-emotional development, and eight were measures including subscales of social-emotional development. Conclusions:  Several measures of infant and toddler social-emotional development have been developed within the last decade. The majority of psychometric data are available through manuals, not peer-reviewed journals. Although all measures show acceptable reliability, the most comprehensive and psychometrically sound measures are the Ages and Stages Social-Emotional, Infant-Toddler Social and Emotional Assessment, Brief Infant-Toddler Social and Emotional Assessment and Child Behaviour Checklist .

49. Summary

50. Quiz time

51. References Books:- Terri Kyle, Susan Carman. Essential of pediatric nursing; Growth and development of toddler,2 nd ed. Wolter’s Kluwer 2013.Pg no-177-211 Wong’s, Essential of pediatric nursing; Developmental & genetics influences on child health promotion,10 th ed. Elsevier publisher. Pg no-125-139 Marlow’s, Textbook of pediatric Nursing ; Normal toddler growth ,development and care, south asian ed. Elsevier publishers,2013 . pg no-583-611

52. OP Ghai , Essential pediatrics,Development,9 th ed. New Delhi, CBS publisher,2019 . pg no-44-49 Journals:- Maiken Pontoppidan et al., parent report measures of infant and toddler;socio economic development, vol 2, issue 34 , April 1 2017, page no.127-137. Butchon and liabsuetrakul , Journal of child and adolescent behaviour , vol 1,issue 5 ,January 2017 .

53. websites :- https://www.cdc.gov/ncbddd/childdevelopment/positiveparenting/toddlers. https://raisingchildren.net.au/toddlers/development/development-tracker-1-3-years/2-3-years https://www.parentingforbrain.com/parallel-play https://www.healthline.com/health/parenting