Schoolj asndj asd qwerwer wefcsdfs dfsdff

ثب صثwefe
wef
wefwefdzfzfsdfsddddddddsdf sdfewe weewwww weff s

1. Growth and development for
school age

2. Middle childhood, ages 6 to 12 years, is probably one of the
healthiest periods of life.
Slow, steady physical growth and rapid cognitive and social
development characterize this time.
During these 6 years, the child’s world expands from the tight
circle of the family to include children and adults at school, at
a workshipcommunity, and in the community at large.
The child becomes increasingly independent.
Peers become more important as the child starts school and
gradually moves away from the security of home.

3. The school-age child develops a sense of industry and learns
the basic skills needed to function in society.
The child develops an appreciationريدقتof rules and
conscience.ريمضلاCognitively, the child grows from the
egocentrism of early childhood to more mature thinking.

4. The school-age years are characterized by slow and steady growth.
The physical changes that occur during this period are gradual and subtle.
قيقد
The average annual weight gain for a school-age child is approximately 3
to 5 lb(1.3 to2.2 kg); the increase in height is 1 to 2 in. (2.5 to 5 cm).
School-age children appear thinner and more gracefulشراةقthan
preschoolers do.
Children who did not lose alordosis and knock-kneed appearance during
the preschool period losethis now.ةلحرملا هذه يف كلأذ نادقف نكمي
Musculoskeletal growth leads to greater coordination and strength. The
muscles are still immature, however, and can be injured from overuse.

5. By 10 years of age, brain growth is complete, so fine motor
coordination becomes refined.
An adult vision level is achieved.
The eruption of permanent teeth and growth of the jaw do not
correlate with final head growth, malocclusion with teeth
malalignment may be present.
ءوس كانه نوكي دقو ،سأرلل يئاهنلا ومنلاب كفلا ومنو ةمئادلا نانسلأا روهظ طبتري لا
نانسلأا فافطصا ءوس عم قابطإ
The immune globulins IgG and IgA each reach adult levels,
and lymphatic tissue continues to grow in size until about age
9 years.
Frontal sinuses develop at about 6 years, so sinus headaches
become a possibility.

6. The left ventricle of the heart enlarges to be strong enough to
pump blood to the growing body.
Cleared heart murmurs may become apparent due to this extra
blood crossing heart valves.
The pulse rate decreases to 70 to 80 beats/min.
Blood pressure rises to about 112/60 mmHg.
Maturation of the respiratory system leads to increase oxygen–
carbon dioxide exchange.

7. Sexual development
The age at onset of puberty varies widely, and puberty is
occurring at an earlier age than previously .
سلا نع ةركبم نس يف غولبلا ثدحيو ،ريبك لكشب غولبلا ةيادب دنع رمعلا فلتخيقبا
Onset of puberty is no longer unusual in girls who are 8 or 9
years old. On the average, African-American girls begin
puberty 1 year earlier than white girls and by age 8 years,
42.9% of African-American girls, as compared to 18.3% of
white girls, demonstrateحضويinitial signs of pubertal
development.
Menarche, the onset of menstruation, occurs, on average,
during the 12
th
year, however, with the decrease in the age of
puberty onset, the age at menarche is also likely to decrease.
عم ،كلذ عمو ،ةرشع ةيناثلا ةنسلا للاخ ،طسوتملا يف ،ضيحلا ةيادب ،ضيحلا ثدحي
ضيحلا نس​​​​ ضفخني نأ اًضيأ لمتحملا نم ،غولبلا ةيادب نس ضافخنا

8. The brain become mature so , the hypothalamus transmits an
enzyme to the anterior pituitary gland to begin production of
gonadotropic hormones, تانومرهاةيلسانتلا ددغلwhich then activate
changes in the testes and ovaries to cause puberty.
Timing of the onset of puberty varies widely, between 8 and 14
years of age partly due to genetic and cultural differences, and
is rated according to Tanner stages .
Sexual maturation in girls usually occurs between the years of
12 and 18; in boys, between 14 and 20 years.
This change in the onset of puberty is important because it
means, for sex education to be effective, parents or schools
must introduce this material as early as when their children are
in grade school. Precociousجوضنلا ركبمpuberty is an abnormal
onset of puberty

9. Age in years Boys Girls
9—11yers Prepubertal weight gain occurs. Breasts: elevation of papilla with
breast bud formation; areolar diameter
enlarges.يدثلا معرب نيوكت عم ةميلحلا عافترا .
ةلاهلا رطق مخضتي
11–12 Sparseرثانتمgrowth of straight,
downy,slightly pigmented hair at
base of penis.
Scrotum becomes textured;
growth of penis and testes
begins.
Sebaceous gland secretion
increases.
Perspirationقرعincreases.
Straight hair along the labia; vaginal
epithelium becomes cornified.
pH of vaginal secretions become acidic;
slight mucous vaginal discharge is
present.
Sebaceous gland secretion increases.
Perspiration increases.
Dramatic growth spurt.
12–13 Pubic hair present across pubis.
Penis lengthens.
Dramatic linear growth spurt.
ةيكيتامارد ةيطخ ومن ةرفط
Breast enlargement may occur.
Pubic hair grows darker; spreads over
entire pubis.
Breasts enlarge, still no protrusion of
nipples.
Axillary hair present.
Menarche occurs.

10. •Epidermal keratinocytes undergo a unique
form of terminal differentiation and
programmed cell death known as
cornification. Cornification leads to the
formation of the outermost skin barrier, i.e.
the cornified layer, as well as to the formation
of hair and nails

11. Concerns of Girls.
تانبلا تامامتها
Prepubertal girls are usually taller by about 2 in. (5 cm) or more than
preadolescent boys because their typical growth spurt begins earlier.
A girl notices the change in her pelvic contour and her hips are
becoming broader.
Early preparation for menstruation is an important preparation for
future childbearing باجنلإاand for a girl’s concept of herself as a
woman.
A girl who is told menstruation is a normal function that occurs
every month in all healthy women has a different attitude toward her
body than a girl who wakes up one morning to find blood on her
pajamas and is told bluntly.ةحارصب
The girl may feel her body is out of control. she can accept and
enjoy growing up if it involves something so unpredictable?

12. Should explain the reason for menstrual flow, girls need an
explanation of proper hygiene and reassurance they can bathe,
shower when their periods.
Girls also need to know that vaginal secretions will begin to be
present. If this is not explained, a girl may fear unnecessarily she has
contracted an infection.
Explain that any secretions that cause vulvar irritation جرفلا جيهت
should be evaluated by a healthcare provider because this does
suggest infection.
Most girls have some menstrual irregularityduring the first year or
two after menarche (the start of menstruation). This occurs primarily
because a girl’s cycles are at first anovulatoryةضابإWith added
maturity and the onset of ovulation, cycles become more regular

13. A girl may fear that irregular periods indicate a hormone imbalance.
She may worry about her future ability to conceiveباجنلإا, or she
may be ill informed about how conception occurs and may fear
irregularity of her periods means that she is pregnant.
Both malnourishment and obesity possibly influence menstrual
regularity.
Emotions can also affect consistentتباثcycles..
If irregularity continues beyond the first year, a careful history of the
girl’s nutrition; overall health; and school, social, and home
adjustment لزنملا ليدعتshould be taken.
Dysmenorrhea, or painful menstruation should be discussed and how
to deal with this period to relive pain

14. Concerns of Boys:
Boys who are not prepared for the physical changes of puberty
worry about them in the same way as girls.
Boys become aware of increasing genital size .
If they do not know testicular development precedesقبسيpenis
growth, they can worry that their growth will be inadequate.
Hypertrophy of breast tissue (gynecomastia) can occur in
prepubescent boys,غولبلا لبق دلاولأاmost often in those who are
obese. A youth with this condition may be concernedناقلقa breast
tumor is present or may feel embarrassed about his growing
breasts.
He can be assured that this is a transitory phenomenon and,
although it makes him self-conscious, will fadeيفتخيas soon as
his male hormones become more mature and active.

15. You can assure them that pubic hair normally appears first
and that chest and facial hair may not grow until several years
later.
As increased seminal fluid begins to be produced, boys begin
to notice ejaculationفذقلاduring sleep, termed nocturnal
emissions.ملاتحلاا
Preadolescent boys may believe the old myth that loss of
seminal fluid is debilitating; also, boys may have heard the
term “premature ejaculation” and worry this is a forewarning
of a problem in years to come. Both are myths.
ئاسلا نادقف نأب ةلئاقلا ةميدقلا ةروطسلأا ةقهارملا لبق ام ةلحرم يف دلاولأا قدصي دق ل
حلطصم دلاولأا عمس امبر ،اًضيأ ؛كهنم رمأ يونملا"فذقلا ةعرس " نورعشيو
ةمداقلا تاونسلا يف ةلكشم نم قبسم ريذحت ةباثمب اذه نوكي نأ نم قلقلاب . امهلاك
ريطاسأ

16. Components of Sex Education
Basic anatomy and physiology.
Body functions.
Expected changes related to puberty.
Menstruation, nocturnal emissions.ملاتحلااو ةيرهشلا ةرودلا
Reproduction.
Teenage pregnancy.ركبملا لمحلا
Human immunodeficiency virus (HIV) infection prevention.
Sexually transmissible disease prevention.

17. Dental
During this school-age years.
All 20 primary (deciduous) teeth are lost and are replacedby
28 of the 32 permanent teeth.
All permanent teeth, except the third molars, eruptعلدنتduring
the school-age period.
ةسردملا نس ةرتف للاخ ،ةثلاثلا سارضلأا ءانثتساب ،ةمئادلا نانسلأا عيمج رهظت
Most first-graders are characterized by a snaggle-tooth
appearance.
ةجرعتملا نانسلأا رهظمب لولأا فصلا بلاط مظعم زيمتي

18. A snaggle-tooth appearance.
Early school-age children typically have a missing upper
incisor as deciduous teeth are replaced by permanent teeth.
ةجرعتملا نانسلأا رهظم . ةركبملا ةسردملا نس يف لافطلأا ىدل نوكي ام ةداع
ةمئادلا نانسلأاب ةينبللا نانسلأا لادبتسا متي ثيح ةدوقفم ةيولع ةعطاق

19. Developmental milestones
Motor Development:
During the school years, coordination improves.
A development sense of balance and rhythm allows children
to ride a two-wheeled bicycle, dance, skip, jump rope, and
participate in a variety of sports.

20. Age in
year
Physical development Psychosocial and cognitive
development
6years year of constant motion; skippingيطخت
is anew skill; first molarsسورضerupt.
First-grade teacher becomes authority
figure; adjustment to all-day school
may be difficult and may lead to
nervous manifestations of fingernail
biting, etc. Defines words by their use
(e.g., a key is to unlock a door, not a
metal object).
دق ؛ةطلس تاذ ةيصخش لولأا فصلا ملعم حبصي
ًبعص اًرمأ مويلا لاوط ةسردملا عم فيكتلا نوكي ا
،رفاظلأا مضق لثم ةيبصع رهاظم ىلإ يدؤي دقو
كلذ ىلإ امو
7 years Central incisors erupt;ةيزكرملا عطاوقلا
difference between sexes becomes
apparent in play (e.g., video games vs.
dolls); spends time in quiet play.
.Learns conservation (e.g., water
poured from tall container to a
wide, flat one is the same amount
of water); can tell time; can make
simple change.
ظفحلا ملعتي(م بوكسملا ءاملا ،لاثملا ليبس ىلع ن
سفن وه حطسمو عساو ءاعو ىلإ ليوط ءاعو
ءاملا ةيمك) نأ نكمي ؛تقولا ةفرعم عيطتسي ؛
اًطيسب اًرييغت ثدحي

21. Ages in year Physical development Psychosocial and cognitive
development
9 years All activities done with friendsFriend or club age; a 9-year-old club
is formed to spite someone, has
secret codes, is all boy or all girl;
clubs disband and reform quickly.
10years Coordinationقسانتimproves Ready for camp away from home;
collecting age; likes rules; ready for
competitive games.ةيسفانت باعلأ
11years Active, but awkward and ungainly
سارملا بعصو اجرحم نكلو ،طشن
Insecure with members of opposite
sex; repeats off-color jokes.
12 years Coordination improves. A sense of humor ةباعدلا سحis
present; is social and cooperative.

22. Importance of Active Play
Coordination and motor skills improve as the child is given an
opportunity to practice.
Children should be encouraged to engage in physical activities.
During the school-age years, children learn physical fitness
skills that contribute to their health for the rest of their lives.
Team sports, such as soccer and baseball, provide
opportunities not only for exercise and improvement of motor
skills.
Obesity has became a major problem in children in the United
States.

23. By 7 years of age, children require more props مئاعدلاfor play
than when they were younger. To be a police officer. a 7-year-
old may need a badge and gun.
Around 7 years of age, children also develop an interest in
collecting items such as baseball cards, dolls, rocks, or marbles
وأ روخصلا وأ ىمدلا وأ لوبسيبلا تاقاطباخرلام
Most girls and boys of this age also enjoy helping in the kitchen
with jobs such as making cookies and salads or frosting cakes.
Many schools begin music lessons for children at about 9 years
of age.

24. Nine years of age is also a time when children use social media.
Many 10-year-olds spend most of their time playing screen
games. Boys and girls play separately at age 10 years, although
interest in the opposite sex is apparent.
During their 10th year, children become very interested in rules
and fairness.فاصنلإا
Club activities become structured, with a president, a secretary,
and rules of order
ماظنلا دعاوقو ،ريتركسو ،سيئر عم ،ةمظنم يدانلا ةطشنأ حبصت
Children age 11 and 12 years enjoy dancing and playing table
games

25. Preventing fatigue and dehydration during long hours of play.
Parent should know signs of fatique.irritability,and to encourage
rest period , increase fluid during day

26. Development of fine motor
Balanced and hand eye coordination improve with maturity
and practice.
Children take pride in activities that require skilled and fine
motor skills …..model building, playing musical instrument,
and drawing.
Six-year-olds can easily tie their shoelaces. They can cut and
paste well and draw a person with good detail.

27. Fine motor development
By 8 years of age, children’s eyes are developed enough so
they can read regular size type. This can make reading a
greater pleasure and school more enjoyable .
Eight-year-olds are able to write scriptيصنلاin addition to
print.
They enjoy showing off this new skill in cards, letters, or
projects.
By age 9 years, their writing begins to look mature and less
awkward. جرحم
Reading and writing are fun. These are activities that can help
a child pass the hours during an illness.

28. Older school-age children begin to evaluate their teachers’
ability and may perform at varying levels depending on each
teacher’s expectations.
The middle school curriculum involves more challenging
science and mathematics courses than previously and includes
good literature.
This may be a child’s first exposure to reading as a fulfilling
and worthwhile experience rather than just as an assignment
and may be the time a child is “turned on” to reading.
مامتهلااب ةريدجو ةيضرُم ةبرجت اهرابتعاب ةءارقلل لفطلل ضرعت لوأ اذه نوكي دق
يذلا تقولا وه نوكي دقو ،ةمهم درجم سيلو"هيف لوحتي "ةءارقلا ىلإ لفطلا

29. EMOTIONAL DEVELOPMENT
Ideally, children enter the school-age period with the ability to
trust others and with a sense of respect for their own worth.
ثلا ىلع ةردقلاب نوعتمتي مهو ةسردملا نس ةرتف لافطلأا لخدي ،ةيلاثملا ةيحانلا نمو ةق
مهتميقل مارتحلااب روعش عمو نيرخلآاب

30. Developmental Task: Industry Versus Inferiority
ةينودلا لباقم ةعانصلا
learning a sense of industry or accomplishment.زاجنإ
If children are prevented from achieving a sense of industry or do
not receive rewards for accomplishment, they can develop a
feeling of inferiorityةينودلاor become influencedرثأتthey cannot do
things they actually can do.
These children can have difficulty tackling ةجلاعمnew situations
later in life (e.g., new job, new school, new responsibility).
because they cannot envisionروصتhow they will be successful in
handling them. This can result in frustrationطابحإin school or work
activities

31. Cognitive development
Intuitive thinking includes animismةيناحورلا لمشي يسدحلا ريكفتلا
Centration.
Egocentrism.ةينانلأا
Concrete operation stage.includs flexibility of thinking.
Problem solving .
Attention span increase.
Reversibility.5+3=8 8-5=3

32. Characteristic of preoperational thinking (to remember)
–Egocentrism ;-ةينانلااviews everything in relation to
self is unable to consider another point of view.
تاذلا لوح زكرمتلا :- ةهجو يف رظنلا عيطتسي لاو هتاذب قلعتي ام لك ىري
ىرخأ رظن
–Animism :-believes that inert objects are alive
and have wills of their own .
ةيناحورلا:-اهب ةصاخ تادارإ اهلو ةيح تانئاك ةلماخلا ماسجلأا نأب نمؤت
–Irreversibility :-cannot see a process in reverse
order
–Magical thought :-believes that magical thought is
the cause of event.
–Centration :-tend to focus on only aspect of an
experience ignoring other possible alternatives.
ةنكمملا ىرخلأا لئادبلا ةلهاجتم ةبرجتلا نم ديحولا بناجلا ىلع زيكرتلا ىلإ ليمت

33. The child move from the intuitive thinking يهيدبلا ريكفتلاof the
preschool year to the logical operationof the school age years,
child gains new knowledge and develops more efficient
problem solving ability and greater flexibility of thinking.
By age 8 years, the child moves into the stage of concrete
operational,سوململا ليغشتلا ةلحرمfollowed by the stage of
formal operational at around 12 years

34. Cognitive development :
The age from 5 to 11 years is a transitional stage where children
undergo a shift from the preoperational thought they used as
preschoolers to concrete operational thought or the ability to reason
through any problem they can actually visualize during school age .
Children can use concrete operational thought because they learn
several new concepts during school age, such as:
Accommodation, the ability to adapt thought processes to fit what is
perceived such as understanding that there can be more than one reason
for other people’s actions.
A preschooler might expect to see the same nurse in the morning who
was there the evening before, whereas a school-age child will
understand that different nurses work different shifts.

35. Conservation,ىلع ظافحلاthe ability to appreciateرِّ دَقُيthat a change
in shape does not necessarily mean a change in size. If you pour
30 ml of cough medicine from a thin glass to a wide one.
Example: the preschooler will say that one glass holds more than
the other; a school-age child will know that both glasses hold an
equal amount.
Class inclusion, the ability to understand that objects can belong to
more than one classification.
Example :A preschooler is able to categorize items in only one
way, for example, stones and shells فادصاare found at the beach; a
school-age child can categorize them in many ways such as by
different materials or by a difference in sizes and shapes, not just
that they are found at the beach.

36. These cognitive developments lead to some of the typical
changes ةيجذومنلا تارييغتلاand characteristics of the school-age
period.
The ability to classify objects leads to the collecting activities
of the school-age period.
Class inclusion is also necessary for learning mathematics and
reading, systems that categorize numbers and words.

37. They can mentally retrace process عاجرتسا ةيلمعa skill necessary
for understanding mathematical problem.
Children can understand and use clock time at around age 8 years
and understand calendar time and memorize dates at age 9 years .
An understanding of conservation of weight develop at 9 to 10
year, and an understanding of volume is present at 11 to 12 years.
رمع يف نزولا ىلع ظافحلا مهف روطتي9 ىلإ10 رمع يف مجحلا مهف روطتيو ،تاونس
11 ىلإ12اًماع.

38. Concrete operations stage :-(7 or 8 year )
Problem solving becomes more efficient and reliable as the
child learns how to form hypotheses , the use of symbolism
becomes more sophisticated, and children now can manipulate
symbols for thing in the way that they once manipulated the
things themselves.
فلا نيوكت ةيفيك لفطلا ملعتي امدنع ةيقوثومو ةءافك رثكأ تلاكشملا لح حبصي ،تايضر
يشلأا زومرب بعلاتلا نلآا لافطلأل نكميو ،اًديقعت رثكأ ةيزمرلا مادختسا حبصيو ءا
مهسفنأب ءايشلأاب لبق نم اهب نوبعلاتي اوناك يتلا ةقيرطلا سفنب
The child learn the alphabet and how to read, attention span
increase as the child grows older facilitating classroom
learning.

39. Classification and logic
Older school age children are able to classify objects according
to characteristics they share to place things in a logical order
and to recall similarities and differences .
Children love to collect and classify stamps, sticker, sports
cards, shells فدصلا, dolls, rocks, or anything imaginable,
school age children understand relationship such as larger and
smaller, lighter and darker.
School age children move away from magical thinking as they
discover that there are logical physical explanation for most
phenomena.

40. Conservation ةظفاحملا.certain prosperities of object don’t
change simply because their order, form or appearance has
changed.eg…..amount of clayنيط.
ظفحلا :اهرهظم وأ اهلكش وأ اهبيترت ريغت درجمل ريغتت لا ءايشلأا صئاصخ ضعب.
لاثملا ليبس ىلع…..نيطلا ةيمك
Understanding of weight developed at 9 or 10 years.
Volume is present at 11 or 12.

41. Classification of logic:
Older school children classify object according to
characteristics they share.
Child love to collect and classify stumps ,stickers, sport cards
,dolls.
Class inclusion …the concept that object can belong to more
than one classification.
Sense of humor.حازم

42. Spiritual and Moral Development
ةيقلاخلأاو ةيحورلا ةيمنتلا
Piaget:
Young school-age children obey rules because powerful, all-
knowing adults hand them down.
فرعي نيذلا ءايوقلأا نيغلابلا نلأ دعاوقلاب ةسردملا نس يف راغصلا لافطلأا مزتلي نو
مهل اهنوملسي ءيش لك.
During this stage, children know the rules but not the reasons
behind them.
Rules are interpreted in a literal way, and the child is unable to
adjust rules to fit differing circumstancesفورظلا.
بسانتل دعاوقلا ليدعت نم لفطلا نكمتي لاو ،ةيفرح ةقيرطب دعاوقلا ريسفت متي
ةفلتخملا فورظلا

43. Jean Piaget's theory of cognitive development
•Jean Piaget's theory of cognitive development
suggests that children move through four different
stages of learning. His theory focuses not only on
understanding how children acquire knowledge, but
also on understanding the nature of intelligence.
Piaget's stages are:
•Sensorimotor stage: Birth to 2 years
•Preoperational stage: Ages 2 to 7
•Concrete operational stage: Ages 7 to 11
•Formal operational stage: Ages 12 and up

44. Fostering Self-Esteem تاذلا مارتحا زيزعت
Give children household responsibilities according to their
developmental level and capabilities.
Set reasonable rules, and expect the child to follow them.
Allow your child to solve problems and make responsible
choices.
Give praise حدمfor what is praise worthy. Do not be afraid to
encourage your child to do better.

45. Sensory development
Eyes fully developed by age 6.
Growth spurt result in myopia .رظنلا رصق ىلإ يدؤت ومنلا ةرفط
Behaviors that parent notice squinting نينيعلا لوحأby:
1-closing to T.V.
2-complaint of frequent headache.
Vision screening yearly should be done.

46. Hearing
Annual audiometric screening tests are important to detect
hearing loss before unrecognized deficits lead to learning
problems.

47. The concept of friendship changes as the child matures.
At 6 and 7 years old, children form friendships merelyد رَجُمon
the basis of who lives nearby or who has toys that they enjoy.
By the time children are 9 or 10 years old, friendships are
based more on emotional bonds, warm feelings, and trust-
building experiences.

48. Kohlberg
Definition: Lawrence Kohlberg's Theory or Moral Development is a
sequential developmental theory in which the notions of adult experience
and moral development converge. Moral growth begins early in life and
continues in stages throughout adulthood until death
ةيرظنجربلوكبلا ةبرجت ميهافم اهيف ىقلاتت ةلسلستم ةيروطت ةيرظن يه يقلاخلأا روطتلا وأ نيغلا
يقلاخلأا روطتلاو . لاوط لحارم ىلع رمتسيو ةايحلا نم ركبم تقو يف يقلاخلأا ومنلا أدبي
توملا ىتح غولبلا ةلحرم
Kohlberg describes children between ages 7 and 12 years as being in
stage 3 of the conventional level .يديلقتلا ىوتسملا
What is the conventional stage?
At the conventional level, conformity to social rules remains important to
the individual. However, the emphasis shifts from self-interest to
relationships with other people and social systems.
A “good-boy” or “good-girl” or orientation characterizes this stage, in
which the child conforms to rules to please others and avoid
disapproval.ضفرلا

49. Family Influenceريثأت
Children manifest antisocial behaviors during middle
childhood. Behaviors such as cheating, شغلاlying, and stealing
are not uncommon.
Parents and teachers profoundly influence moral development.
يقلاخلأا روطتلا ىلع قيمع لكشب نوملعملاو ءابلآا رثؤي
Parents can teach children the difference between right and
wrong most effectively by living according to their values.

50. Spirituality and Religion
Spiritually, school-age children become acquainted with the
basic content of their faith.
يساسلأا ىوتحملا ىلع ةسردملا نس يف لافطلأا فرعتي ،ةيحورلا ةيحانلا نمو
مهناميلإ.
Children reared within a religious tradition feel a part of their
religion.
نيذلا لافطلأا رعشينوأشنيمهنيد نم ءزج مهنأب ةينيدلا ديلاقتلا نمض.

51. Nutritional Requirements
Growth continues at a slow, regular pace,ةمظتنم ةريتوbut the
school-age child begins to have an increased appetite.
Energy needs increase during the later school-age years.
Children in this age-group tend to have few eating
idiosyncrasies تايصوصخلاand generally enjoy eating to satisfy
appetite and as a social function.

52. Dietary recommendations for school-age children include
2 ½ cups of variety of vegetables;
1 ½ cups of variety of fruits; هكاوفلا نم ةعونتم ةعومجم.
5 ounces of grains بوبحلا نم ةيقوأ(half of which should be
whole grain);
5 ounces of protein (lean meat, poultryنجاود, fish, beans);
and 3 cups of fortified nonfat milk or dairy products.

53. A Vegetarian Diet
School-age children who are vegetarians or vegansنييتابنneed to
learn how to obtain essential nutrients whether they pack their lunch
or purchase ءارشit at school.
The consumption ofadequate protein and calcium is important for
muscle, bone, and dental development.
Foods highest in calcium are green leafyةيقرولاvegetables such as
spinach and turnipتفللاgreens, enriched bread, and cereals.
Soybeans,ايوصلا لوفlegumes,تايلوقبلاgrainsتايلوقب, and immature
seedssuch as green beans, lima beansايلوصافلا, and corn are relatively
high in protein.
Encourageoutside activities for sun exposure to increase vitamin D.

54. Dental Care
Malocclusion: Good occlusion, or alignment, of the teeth is
important for tooth formation, speech development, and physical
appearance.
Many school-age children need orthodontic braces
ةيميوقتلا ساوقلأاto correct malocclusion, a condition in which is the
teeth are crowded,, crookedةيوتلمor out of alignment.
Factors such as
Heredity.
Cleft palate.
Premature loss of primary teeth, and mouth breathing lead to
malocclusion.
Thumb sucking is not believed to cause malocclusion unless in
persists past age 5 or 6 years.

55. •Preventing Dental Injuries.
•Dental Health Education.

56. PROMOTING DEVELOPMENT OF A SCHOOL -AGE
CHILD INDAILY ACTIVITIES.
Dress:
Although school-age children can fully dress themselves, they
are not skilled at taking care of their clothes until late in the
school-age years.
School-age children have definite opinions about clothing
styles, often based on the likes of their friends, a popular sport,
or a popular musician يقيسومrather than the preferences of
their parents.

57. Sleep and Rest:
The number of hours spent sleeping decreases as the child
grows older.
Children ages 6 and 7 years need about 12 hours of sleep per
night. Some children also continue to need an afternoon quiet
time or nap to restore energy levels.
Occasionally, school-age children have sleep problems, most
commonly sleepwalking and sleep terrors بعرلا(night terrors).
Both conditions occur during deep sleep.
Most 6-year-olds are too old for naps but do require a quiet time
after school to get them through the remainder of the day.
Nighttime terrors may continue during the early school years
and may actually increase during the first-grade year as a child
reacts to the stress of beginning school.

58. Discipline: بيدأت
Firm, consistent limits increase children’s sense of security
and reinforce ززعتthe message that an adult cares about them.
يتلا ةلاسرلا ززعتو ناملأاب لافطلأا روعش نم ديزت ةقستملاو ةمراصلا دودحلا نإ
مهب متهي غلابلا صخشلا نأ اهدافم

59. Safety.
Car safety.
Fire and burn safety.
Bicycle , in-line skating scooter, جلزتلا رتوكسand Skateboardجلزت حول
Safety.
Pedestrian ةاشمSafety. ةاشملا رمم
Water Safety.
Patient –Centered Teaching

60. Parent should help adjust the belts so that the lap belt fits snugly
over the bony pelvis and the shoulder harness is positioned
across the chest.
Fire Safety Rules:
1-Know two specific escape routes from each area in the home .
2-Know how to access number.
3-Have a predetermined meeting area outside the house .
4-Never return to a burning house.
5-Practice fire drills.قئارحلا ىلع تابيردتلا ةسرامم
6-Parent need to invest the time to teach their children how to
use tools and appliancesةزهجلأاproperly and must establish
guidelines to avoid burn injuries as a result of the child
inexperience.

61. Bicycle safety practices actually begin when the child learns to
ride a tricycle and progressively build as the child becomes more
skilled and begins to ride a bicycle , a helmet ةذوخand other
safety accessories are essential for protection .
Helmet and protective pads covering knee and elbows help to
protect the most vulnerable area of the child body from serious
injury .

62. Pedestrian safety ةاشملا ةملاس
Between the ages of 5, and 9 years at the greatest risk for auto
pedestrian injuries. ريسلا ثداوح
Children are commonlystruck تباصأwhen they dart into traffic ,
especially where parked cars obscure the drivers view of the
child e .g crossing the street in front of a school bus playing near
cars in driveways or yards.

63. Children in this age group have the misconception that if they
can see the car the driver must be able to see them and will be
able to stop instantly.
Children learn traffic safety by watching and doing exposure
to traffic increase as the child begins to walk to and from
school and friends house

64. Water Safety
To swim well enough to keep their head above water for a
short time at about 8 years old.
Advise parents to teach children to wade ضوخلاinto shallow
water or to jump feet first into water of unknown depth to
prevent neck injuries .
Safety near the water includes never running pushing or
jumpingon other who are in the water.

65. Selected Issue related to school-age.
Peer influence.نارقلأا ريثأت.
Influence of teachers.
Parent’s Role.
School refusal.
Helping a child overcome school refusal.
ةسردملا ضفر ىلع بلغتلا ىلع لفطلا ةدعاسم

66. Adjustment to school ةسردملا عم فيكتلا
Most children are ready to start school particularly if they
have older sibling, children starting school may be a
frightening experience , even children who have attended
preschool have some anxiety about beginning first grade.
Adjustment to school depends on a variety of factors
including the child physical and emotional
Maturity, the child experiences, and the parents ability to
support the child accept the separation
From peers children learn how to cooperate, compete,ةسفانملا
bargain, واسماةand follow rules.
Peer approval is of major importance as children look to their
friends for recognition فُّرعتand support.

67. An effective teacher makes learning fun and capitalizes on the
child interests and talent .بهاوملا
Teacher guide the child learning by rewardingيزجمsuccess
and helping the child learn from and deal with failures.
The teacher plays an important role in preventing feeling of
inferiority ةينودلاin the child .
By structuring the learning environment so that the child
experiences success the teacher bolsters ززعيfeelings of
industry.
The child must create and adhere to a schedule for completing
large assignments to prevent last minute panic.رعذ

68. The television should be turned off during study time and
distractions kept to a minimum, adequate sleep is
important for school performance.
School Refusal
School refusal is a descriptive term for behavior that may
indicate the presence of a specific phobia separation
anxiety truancy ةسردملا نع بيغتلاor social phobia.
School phobia need to be defined both symptomatically
and operationally to determine if its cause is related to
anxiety .

69. Some school refusing children show specific fears of school or
school related situation ( tests, Bullies,نورمنتملاteacher
reprimands,خيبوتلاundressing for gym يضاير يدان) .
Children may go to school unwillinglyضضم ىلعor may refuse
and have temper tantrumبضغ ةبونif the parent insist on taking
the child to school , younger children may complain of
stomachaches.
Headache.
nausea, and vomiting .
Other children may complain of
palpitation .
feeling faint, these symptoms typically resolve when the child
returns home

70. Self-care children:
Children who take care for themselves like dressing ,cleaning
.eating ,and bathing after school while left alone .
The number of children who let themselves into their home
after school and are left alone to continue to grow as the
number of dual جودزمincome and single parent families
increase. Potential positive outcome are learning to be
independent and responsible.
Nurse help families by offering support and education to
parent to reduce the risks for self-care children.

71. Obesity:
can be a precursor ريذنof hyperlipidemia, sleep apnea,
orthopedic problems hypertension and diabetes.
Risk factors:
Cultural
genetic
behavioral environmental socioeconomic factors are linked to
obesity.
Assessing the scope of the problem: caused by increased
calories intake, decreased physical activity.
Prevention: Regular exercise healthy eating habit .

72. How to prevent and manage Obesity:
1-Do not use food as a reward.ةأفاكم
2-Establish consistent times for meals and snacks and discourage
in-between eating.
3-Offer only healthy food options (ask the child to chose between
an apple or popcorn,راشفلاnot an apple or a cookie تيوكسب.
4-Avoid keeping unhealthy food in the house and minimize trips
تلاحرto fast-food restaurants.
5-Be a role model by improving your own eating habits and levels
of activity.

73. Stress:
Source of Stress in children:
1-School pressure.
2-Physical threats.
3-Competitive sports.ةيسفانتلا تاضايرلا.
4-Tight schedules and adaptation overload.
5-Family pressure.
6-Media influence.يملاعلإا ريثأتلا
7-Peer Victimization.نارقلأا ءاذيإ

74. Peer victimization
Often called bullyingرمنتis a problem for school age children.
Strategy to deal with it:
( speak up.
walk away.اديعب شما
tell someone, don’t react لا ،ادحأ ربخأ متهت ).

75. Growth And Development
During Early Childhood

76. Growth And Development During
Early Childhood( Toddler)

78. The toddler years are characterized by struggleحافكfor autonomy
as the child developed a sense of self separation from the parent ,
toddler explore the environment and master new skills .
Toddler egocentric and demanding behavior , often marked by
temper tantrumsand negativism, have given this age the label the
terrible twos. بضغلا تابونب مستي ام اًبلاغ ،بلطتملاو ينانلأا لفطلا كولس
علا اذه ىطعأ ،ةيبلسلاومةبيهرلا تايئانثلا ةيمست ر
Parental guidance is needed to handle the negativism, temper
tantrums,،بضغلا تابونand sibling rivalryءاقشلأا سفانتthat are
characteristic of this age group.
The preschooler becomes increase independent mastering many
self care and motor skills And developing greater social and
emotional maturity , imagination , creative. عدبم

79. Physical Growth and Development
•The Toddler:-
•Weight gain is 2.5 kg /year .
•Body mass index (BMI) screening is completed at 24 months
to identify toddlers who are overweight or underweight.
•A child birth weight has quadrupled by age 2 to 3 years .
•Height (12 cm) a year during the toddler period
•Height average 7.5 cm /years .
•Head circumference increase 2 cm during the toddler years
,compared with the growth of 12 cm in the first 12 month .
•, chest circumference should have grown greater than that of
the head.

80. •Body contour:
•Immature abdominal musculature give the toddler a
potbellied appearance نطب رهظم. Toddlers tend to have a
prominent abdomen.
•With an exaggerated lumber curve the child short legs
appear slightly bowed, and the feet seem flat because of
a plantar fat pad that disappears around the age of 2
years .
•They also have a forward curve of the spine at the sacral
area (lordosis). As they become more experienced at
walking, this will correct itself naturally.

81. Toddler a potbellied appearance . Toddlers tend to have a
prominent abdomen because their abdominal muscles are not yet
strong enough to support abdominal contents as well as they will
be able to do later

82. Bowes legs in toddler

83. Lordosis in toddler (have a forward curve of the
spine at the sacral area (lordosis).

84. •Body Systems:
•Body systems continue to mature during this time.
• Respirations slow slightly but continue to be mainly
abdominal.
• Heart rate slows from 110 to 90 beats/min.
• Blood pressure increases to about 99/64 mmHg.
• The brain develops to about 90% of its adult size.
• In the respiratory system, the lumens of vessels
enlarge progressively so the threat of lower respiratory
infection lessens.

85. • Stomach secretions become more acid; therefore,
gastrointestinal infections also become less common.
• Stomach capacity increases to the point a child can eat
three meals a day.
• Control of the urinary and anal sphincters becomes
possible with complete.
myelination of the spinal cord so toilet training is
possible.
• Immune globulin (Ig)G and IgM antibody production
becomes mature at 2 years of age.
The passive immunity obtained during intrauterine life is
no longer operative.

86. Teeth:
Eight new teeth (the canines and the first molars) erupt during the
second year. ةديدج نانسأ ةينامث رهظت(ىلولأا سارضلأاو باينلأا )ةيناثلا ةنسلا للاخ
All 20 deciduousةطقاستملاteeth are generally present by 2.5 to 3 years
of age.
Deciduous teeth play an important role in the growth and
development of the jaws and face and in speech development ,
premature loss of the deciduous teeth complicated eruption of the
permanent teeth. ةمئادلا نانسلاا

87. All 20 deciduous teeth are generally present
by 2.5 to 3 years of age.

88. Growth spurts تارفطareshort periods of time when the child
experiences quick physical growth in height and weight.
Growth spurts are a normal part of child's development and
occur at different stages of their childhood until they reach
physical maturity.

89. Acceleration : عراست

90. Developmental milestones: are a set of functional skills or age-
specific tasks that most children can do at a certain age range.
Some children achieve their developmental milestones earlier
and some later than other children. Some are able to speak earlier
than others, but walk later.
Most developmental delays in children are not serious, and
children eventually ًارخؤمcatch up with their peers. However, if a
more serious delay or a disability is present, providing help early
is important in helping the child reach his full potential.لمتحم


91. Knowing the developmental milestones for different ages
helps parents, teachers, and healthcare professionals
understand normal child development and also aids in
identifying potential problems with delayed development.
Developmental delays :exist when a child does not reach
his/her milestones at about the same time as other children the
same age.

92. •The developmental milestones of the toddler years are
less numerous but no less dramatic than those of the
infant year because this is a period of slow and
steady, not sudden, growth.
أ تسيل اهنكلو ًاددع لقأ راغصلا لافطلأا تاونس يف ةيومنتلا ملاعملا نإ لق
ءيطب ومن ةرتف هذه نلأ عيضرلا تاونسب ةصاخلا كلت نم ةيكيتامارد
اًئجافم سيلو ،تباثو
•Toddler development is influenced to some extent by
the amount of social contact and the number of
opportunities children have to explore and experience
new degrees of independence

93. DEVELOPMENTAL MILESTONES for toddler
•15 months Fine Motor:
•Puts small pelletsتايركلاinto small bottles.
•Scribbles voluntarily with a pencil or crayon.نيولت ملق وأ صاصر ملقب ةيعاوط ةطبخشلا
•Holds a spoon well but may still turn it upside down on the way to mouth.
•Binocular vision is well established by age 15 months. Visual acuity is
about 20/40 by 2 years of age.
•Gross Motor:
•Walks alone well;
•can seat self in chair; can creep up stairs .
•Learning to walk well is the crowingحايصachievement of the toddler, take a
few steps, fall, and repeat the process over and over obliviousلفاغto bumps
and bruises.تامدك
•Language :
•4-5 words.
•Play.
•Can stack two blocks; enjoys being read to; drops toys for adult to recover
(exploring sense of permanence
• نيتلتك سيدكت نكمي . يفاعتلل رابكلل باعلأ طاقسإ ؛هل ةءارقلاب عتمتسي(وميدلاب روعشلا فاشكتساةم

94. Puts small pellets into small bottles.

95. Can stack two blocks

96. Scribbles voluntarily with a pencil or crayon.

97. 18months fine motor :
No longer rotates a spoon to bring it to mouth .
Gross motor :
Can run and jump in place.
can walk up and down stairs holding onto a person’s hand or
railing; typically places both feet on one step before
advancing.نيزبرد

99. •Language development :
•7–20 words; uses jargoning تاحلطصملا; names one body
part.
•Urge parents to encourage language development by
naming objects (e.g., ball, block,زجاحmusic box, doll) as
they play with their child or when they give the toddler
something (“Here is your drink of water,” “Let’s put on
these pajamas,
•Play:
•Imitates household chores such as dusting; begins
parallel play (playing beside, not with, another child)
يزاوتملا بعللا أدبي ؛رابغلا ةلازإ لثم ةيلزنملا لامعلأا دلقي
(هعم سيلو رخآ لفط بناجب بعللا)

100. parallel play (playing beside, not with, another
child)

101. 24months fine motor:
Can open doors by turning doorknobs; unscrew lids . ةيطغلأا كف.
Gross motor :
Walks up stairs alone, still using both feet on same step at same time.
By 24 months can put on simple items of clothing but cannot differentiate front to
back, also can zip large zippersةريبكلا ةتسوسلاput on shoes ,and wash and dry their
hands.
Two years old brush their teeth but need help in adequately removing plaque.
Feeding, dressing and play provide opportunities for the child to development
autonomy.
Language:
50 words; two word sentences (noun or pronoun and verb), such as “Daddy
go,” “Dog talks” .
Play:
Parallel play evident
حضاو يزاوملا بعللا

102. Can open doors by turning doorknobs;
unscrew lids .

103. Child proof door

104. 30 months:Finemotor :
Makes simple lines or strokes for crosses with a pencil.
صاصر ملق مادختساب نابلصلل ةطيسب تابرض وأ اًطوطخ مسري
Gross motor:
Can jump down from chairs
Language:
Verbal language increasing steadily; knows full name; can name one color
and holds up fingers to show age
Play:
Spends time playing house, imitating parents’ actions; play is
“roughhousing” or active
بعللا ؛نيدلاولا تافرصت ديلقتو ،لزنملاب بعللا يف اًتقو يضقي"نشخ "طشن وأ

105. Jump from chairs

106. Emotional Development
•1-Autonomy: Erikson.
•The developmental task of the toddler years according to Erikson
is the development of a sense of autonomy versus shame or
doubt.كشلا وأ لجخلا لباقم ةيللاقتسلااب روعشلا
•Children who have learned to trust themselves and others during
the infant year are better prepared to do this than those who have
not learned to trust themselves or others.
•To develop a sense of autonomy is to develop a sense of
independence.
•A healthy level of autonomy is achieved when parents are able to
balance independence with consistently sound rules for safety..
•The senses and motor abilities of the toddler do not function
independently of one another
ضعبلا اهضعب نع لقتسم لكشب لفطلا ىدل ةيكرحلا تاردقلاو ساوحلا لمعت لا
•Tow year-old toddlers reach, grasp,كسميinspect, smell, taste, and
study objects with their eyes.

107. •Socialization:
Once toddlers are walking well, they become resistant to sitting
in laps نضحand being cuddled.نضتحيThis is not lack of a
desire for socialization but a function of being independent
At 15 months, children are still excited سمحتمabout interacting
with people, providing those people are willing to follow them
where they want to go.
ىلع صاخشلأا ءلاؤه نوكي نأ طرشب ،سانلا عم لعافتلل نيسمحتم لافطلأا لازي لا
باهذلا نوديري ثيح مهتعباتمل دادعتسا
By 18 months, toddlers imitate ديلقتلاthe things they see a parent
doing, such as “study” or “sweep,”طيشمتso they seek out
parents to observe and imitate.
. By 2 or more years of age, children become aware of gender
differences and may point to other children and identify them
as “boy” or “girl

108. 3-Play Behavior:
Play is the work of a toddler. Through play, toddlers learn how
to manipulate and understand their environment, socialize, and
explore their world.
All during the toddler period, children play beside other
children, not with them. This side-by-side play (parallel play)
is not unfriendly but is a normal developmental sequence that
occurs during the toddler period.
Toddlers prefer pots and pans from the kitchen, supervised
water play, dancing to music, and crayons or finger paint and
paper.

109. •The toys toddlers enjoy most are those they can play with by
themselves and that require action. Trucks they can make
go, rocking horses they can ride, لويخو ،اهليغشت مهنكمي تانحاش
،اهبوكر مهنكمي ةزازه
•These are all toys children can control, giving them a sense
of power in manipulation,ةعراب ةجلاعمwhich is an expression
of autonomy

110. The best play potsيناولأاand pans يلاقملاfrom the
kitchen

111. At 15 months of age, children are still continue to enjoy stacks
of boxes that fit inside each other. They enjoy throwing toys
out of a playpen or from a high chair tray as long as someone
will pick them up and return them again and again.
By age 2 years, when toddlers begin to spend time imitating
adult actions in their play such as wrapping a dollةيمد فيلغت
and putting it to bed or “driving the car,” they begin to use fewer
toys than before.
By the end of the toddler period, both boys and girls begin to
like roughhousing and spend at least part of every day in this
very active, stimulating type of play Encouraging parents to
schedule this type of play outdoors,
نشخلا بعللا بح يف تانبلاو دلاولأا نم لك أدبي ،ريغصلا لفطلا ةرتف ةياهن لولحب
ةياغلل زفحملاو طشنلا بعللا نم عونلا اذه يف موي لك نم لقلأا ىلع اًءزج نوضقيو .
،قلطلا ءاوهلا يف بعللا نم عونلا اذه ةلودج ىلع ءابلآا عيجشت

112. Imitating adult actions

113. Psychosexual development
At18 months toddler enter Freud's anal stage , that as children
focus on mastery of bowel and bladder function , also directed
to the genital area .
By 2year child aware gender .
By 3year can correctly identify anatomic pictures of boys and
girls .
Encouraging parent to make traditional gender typed toys
available to both boys and girls .
In most cultures boys and girls are treated differently and thus
are taught male and female behaviors .
Sex play and masturbation ءانمتسلااare common in toddler .

114. Nursing can reassure parent that self exploration or exploration
of another toddler body is normal behavior during early
childhood.
When parent discover children involved in sex play casually
telling them to dress and directing them to another activity can
limit sex play without producing feeling of sham or anxiety
مهرابخإ نإف ،سنجلا نوسرامي مهلافطأ نأ لهلأا فشتكي امدنع
نكمي رخآ طاشن ىلإ مههيجوتو مهسبلام ءادتراب يضرع لكشب
قلقلا وأ لجخلاب روعشلا نود يسنجلا بعللا نم دحي نأ

115. Cognitive Development
As a toddler, a child enters the final stages of Piaget’s sensorimotor thought
and the beginning of the preoperative period at approximately 12 months
Toddlers are described as “little scientists” because of their interest in trying to
discover new ways to handle objects or new results that different actions can
achieve., toddlers need supervision for these types of scientific investigations
because they can lead to errors or injury.
Learning in this stage occurs mainly by the trial and error.
Most of day is busy to see what will happen as they dump fillا ءلملرفاغ ,empty
and explore every accessible area of their environment
Object permanence is firmly establish by this age
علا اذه يف ةوقب نئاكلا ةموميد سيسأت متيمر
Object permanencedescribes a child's ability to know that objects
continue to exist even though they can no longer be seen or heard.
اهتيؤر نكمملا نم دعي مل ول ىتح ةدوجوم لازت لا ءايشلأا نأ ةفرعم ىلع لفطلا ةردق ءايشلأا ءاقب فصي
اهعامس وأ.
Example. if you place a toy under a blanket, the child who has achieved
object permanence knows it is there and can actively seek it.

116. Characteristic of preoperational thinking
–Egocentrism ;-ةينانلااviews everything in relation to
self is unable to consider another point of view.
تاذلا لوح زكرمتلا :- ةهجو يف رظنلا عيطتسي لاو هتاذب قلعتي ام لك ىري
ىرخأ رظن
–Animism :-believes that inert objects are alive
and have wills of their own .
ةيناحورلا:-اهب ةصاخ تادارإ اهلو ةيح تانئاك ةلماخلا ماسجلأا نأب نمؤت
–Irreversibility :-cannot see a process in reverse
order
–Magical thought :-believes that magical thought is
the cause of event.
–Centration :-tend to focus on only aspect of an
experience ignoring other possible alternatives.
ةنكمملا ىرخلأا لئادبلا ةلهاجتم ةبرجتلا نم ديحولا بناجلا ىلع زيكرتلا ىلإ ليمت

117. Egocentrism example
•if you wake up late and go to school in a stained sweater,
you may think that everyone noticed. This occurs primarily
due to the egocentric bias: we are so focused on ourselves
that we forget others are also occupied with themselves or
whatever they are doing

118. Animism example
•include water sprites, vegetation deities, and tree spirits,
among others. Animism may further attribute a life force
to abstract concepts such as words, true names, or
metaphors in mythology.
اهريغو راجشلأا حاورأو تاتابنلا ةهلآو ةيئاملا تيرافعلا لمشت . حاورلأا بسنت دق
تاراعتسلاا وأ ةيقيقحلا ءامسلأا وأ تاملكلا لثم ةدرجم ميهافم ىلإ ةايحلا ةوق اًضيأ
ريطاسلأا يف

122. Children at this stage have a type of faulty reasoning (prelogical
reasoning) that can lead them to wrong conclusions and faulty
judgment
At the end of the toddler period, children enter a second major
period of cognitive development termed preoperational thought
and begin to use a process termed assimilation.باعيتسلاا
Piaget believed that there are two basic ways that we can adapt
to new experiences and information: assimilation and
accommodation.
Assimilation is the easiest method because it does not require a
great deal of adjustmentليدعت. Through this process, we add new
information to our existing knowledge base, sometimes
reinterpreting these new experiences so that they will fit in with
previously existing information.

123. Language Development
The Toddler :-
Between 15 and 24 months language ability develops rapidly
Toddler understand many more words then they can say
because receptive language.
Sometime after 18 months many children experience a sudden
spurt ةعرسin speech production and comprehension , resulting
in a vocabulary of 300 or more words at 24 months.
By 2 year roughly 60% to 70% of toddlers speech should be
understandable .

124. Parent can promote language development by talking to their
child and incorporating جمدteaching into daily routines .
Feeding, bathing, dressing, and going on outing to both new
and family placed offer opportunities for verbal interaction and
the practice of growing language skills.
The child should be encouraged to express needs rather than
the parent anticipating عقوتand providing what the child wants
before the child asks for it

125. PROMOTING TODDLER SAFETY
Accidents (unintentional injuries) are the major cause of death in
infants through late adolescents in the United States (CDC, 2012a).
Unintentional ingestions (poisoning) and auto accidents are the types
of unintentional injuries that occur most frequently in toddlers.
poisoning can involve medicine such as acetaminophen ,.
Aspiration or ingestion of small objects such as watch or hearing aid
batteries, pencil erasers, or parts of crayons نيولت ملاقأis also a major
danger for children of this age .
Urge parents to childproof their homeنم مهلزنم ةيامح ىلع نيدلاولا ثح
فطلأالاby putting all poisonous products, drugs, and small objects out
of reach by the time their infant is crawling, and certainly by the time
their infant is walking, to avoid these problems.

126. Other unintentional injuries that occur frequently in toddlers
include
motor vehicle accidents,.
burns,.
Falls.
drowning, and playground injuries.
These occur because toddlers’ motor ability jumps ahead of
their judgment. To prevent serious injury, teach parents to be
alert as to what their toddler is doing at all times.
For safety in automobiles, parents should keep their toddlers in
rear-facing seats until age 2 years, or until the child reaches the
maximum height and weight for their particular seat.

127. Falling safety from stairs

129. Should be prevent toddler from falling

130. Should be prevented from aspiration

131. Toy safety for toddler should be large to
prevent aspiration

132. Motor vehicle safety

133. Bathroom hazards should be kept in closed
cupboard

134. Buckets ;ولد

135. Drowning safety for toddler its family
responsibility

136. children need to ride in a car seat with a five-point restraint
Car seats should be placed in the back seat so the child is not
struck by the passenger seat airbag.
Remind parents that it is unsafe to leave a toddler alone in a
car.
One way for a parent to be reminded that the child is in the
back seat is to always place apurse دعقمor briefcase in the
back seat alongside the child’s car seat.
Toddlers need to wear a helmet as soon as they begin riding a
tricycle.
UNINTENTIONAL INJURY PREVENTION MEASURES
FOR TODDLERS chapter (box) 30 page 1791

137. Lead Screening:
The CDC has set as a goal the elimination of elevated blood lead levels in
children.
All children between the ages of 6 months and 6 years who live in
communities with buildings builtbefore 1950 and immigrant children who
might have been exposed to sources of lead in another country should be
tested for the presence of lead in their body (lead poisoning).
 ماع لبق1950 دلب يف صاصرلا رداصمل اوضرعت امبر نيذلا نيرجاهملا لافطلأا رابتخا بجيو ،
مهداسجأ يف صاصرلا دوجو نم دكأتلل رخآ(صاصرلاب ممستلا)
Because lead is toxic to body tissue, ingestion of it leads to
1-serious damage to the brain and nervous system, kidneys, and red blood
cells.
2-Levels as low as 5 μg/dl can cause learning and behavioral problems.
3-High levels may result in seizures, cognitive challenges, coma, and even
death.
The CDC (2012b) recommends screening for all children between the ages
of 9 and 12 months at least once and again at 18 or 24 months of age. A

138. Toddler Nutrition Requirements
Parents may become frustratedطبحمwhen trying to provide
adequate nutrition for their toddler because of a toddler’s
varying and unpredictable appetite and food preferences.
Sedentary (inactive ) children ages 1 to 3 years should
consume 1,000 kcal daily; active children in this age group
may need up to 1,400 kcal daily.
Adequate calcium and phosphorus intake is important for bone
mineralization. Milk should be whole milk until age 2 years.
Calories are best supplied by a variety of foods spaced into
three meals a day.
fat coming from sources of polyunsaturated and
monounsaturated fatty acids, such as fish, nuts,تارسكملاand
vegetable oils, the same as adults.

139. By age 1 year most children are eating the same food as the
rest of the family , toddler should be offered three meals and
two health snacks ةفيفخ تابجوeach day , most 2 year old's can
drink from a cup and use a spoon well if given the opportunity
to practice.
•After 2 year, low-fat (2%) milk may be given , milk intake
should be limited to 2 or 3 cups /day, yogurtيدابزand cheese
are other milk group sources , .
•poultry, fish, and lean meat are good sources of iron , low
sugar breakfast cereals are sources of iron and vitamins.
•snacks of fruits and vegetables assist in meeting the child
nutritional requirements.
•Food jags :
•The volume of food the child eats may vary from day to day ,
the child may want the same food at every meal for several
days and then suddenly reject the food completely, they may
not like mixing food , many children prefer juices to milk and
water.

140. 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.
1-Dressing :
By the end of the toddler period, most children can put on their
own socks and underpants .
Some may also be able to pull on trousers, pullover shirts (the
sleeves of a shirt often confuse a toddler), or simple dresses.

141. By 24 month can put on simple items of clothing but cannot
differentiate front to back, also can zip large zippers, باحس نكمي
ةريبكلا ةتسوسلاput on shoes ,and wash and dry their hands. they
habitually put shoes on the wrong feet.
If they feel they must change the child’s clothes, urge them to begin
with a positive statement, such as “You did a good job,” before
making the switch.

142. 2-Sleep:
The amount of sleep children need gradually decrease as they
grow older.
They may begin the toddler period napping twice a day and
sleeping 12-14hours each night and end it with one to two nap
.
If a child has difficulty falling asleep at night, it may be time to
omit or shorten an afternoon nap.
Some toddlers begin having night terrors or awake crying from
a bad dream and so may receive little sleep because they are
reluctant لساكتمto fall back asleep.

143. Other toddlers resist naptime as part of their developing
negativism.
The parent can state simply, “It’s naptime now,” and then give
a secondary choice: “Do you want to sleep with your teddy
bear or your rag doll.كب صاخلا ةقرخ ةيمد وأ كب صاخلا بد ةيمد عم
Toddler often resist going to bed , using dawdling or even
temper tantrums to postpone separation from loved ones and
the exciting events of the day.
ىتح وأ مهؤطابت نيمدختسم ،ريرسلا ىلإ باهذلا راغصلا لافطلأا مواقي ام اًبلاغ
مويلا يف ةريثملا ثادحلأاو مهئابحأ نع لاصفنلاا ليجأتل بضغلا تابون.
Children of this age often have trouble relaxing and falling
asleep, warm bath before bed time promotes relaxation.

144. a toddler loves a bedtime routine: bath, pajamas, a story,
toothbrushing, being tucked يوطمinto bed, having a drink of
water, choosing a toy to sleep with, and turning out the lights.
toddlers like to see parents as firm, consistent people.
نيقستمو نيمزاح صاخشأك مهيدلاو ةيؤر راغصلا لافطلأا بحي
Remind parents to stress that sleeping in a regular bed does not
give children the right to get in and out of bed as they choose.
This arrangement gives them a feeling of independence but
still keeps them safe.
Put side rails for crib to prevent sleeping on floor or Dressing
the child in warm pajamas or putting a blanket on the floor to
protect child be solutions to help parents accept this.

145. Tips for dealing with a toddler who's
resisting bedtime:
Promote relaxation. Before bed, consider a warm bath or
quiet reading. .
Set a routine. Performing the same steps every night
helps your child to get used to a sleep routine. ...
Keep him active during the day.
Cuddle child .
Read story
Emphasize time together. ..
Transition object, such as a favorite blanket or stuffed
animal, are often an important part of child bed time
routine.

146. 3-Bathing:
The time for a toddler’s bath should depend on the parents’
and the child’s wishes and schedule.
Toddlers usually enjoy bath time, and parents should make an
effort to make it fun by providing a toy, such as a rubber duck
or plastic fish.
Bath time is usually so enjoyable for toddlers that parents can
use it as a recreational activity.
Remind parents toddlers can sit well in a bathtub, it is still not
safe to leave them unsupervised.
Parents shouldn’t add bubble bath to the water because its use
is associated with vulvovaginitis and possibly urinary tract
infections, especially in girls

148. Parallel play is important for toddler development

149. Dental care for toddler (pediatric dentist )

150. 4-Dental Care:
Toddlers often need between-meal snacks. To help prevent
dental caries from frequent snacking.ةفيفخ تابجو لوانت
encourage parents to offer fruit (e.g., bananas, pieces of apple,
orange slices) or protein foods (e.g., cheese, pieces of chicken)
for snacks rather than high carbohydrate items such as cookies
to limit exposure of the child’s teeth to carbohydrate.
Calcium (found in large amounts in milk, cheese, and yogurt)
is especially important for the development of strong teeth and
so are other good snack foods.

151. Remind parents not to put a child to bed with a bottle of milk
or juice to help prevent the development of caries.
Toward the end of the toddler period, they can begin to do the
brushing themselves under supervision.Because toddler like to
imitate, watching parent brush their teeth can be motivating,
small soft, nylon bristle brush works best.
هنانسأ نوفظني مهو نيدلاولا ةدهاشم نإف ،ديلقتلا نوبحي راغصلا لافطلأا نلأ اًرظن م
نوليانلا نم ةعونصملا نشخلا رعشلا تاذ ةريغصلا ةاشرفلاف ،اًزفحم نوكي نأ نكمي
لضفأ لكشب لمعت
Fluoride makes tooth enamel انيملاresistant to acid attack
preventing decay.
A diet that is low in sweets and high in nutritious food
promotes dental health.
Remind parents that it is better for a child to brush thoroughly
once a day, probably at bedtime.

152. Urge parents to schedule a first dental visit with a dentist
skilled in pediatric dental care by 12 months of age.
Screenings and assessment of dentition can begin as early as 6
months of age but should occur no later than 24 months of age

153. Tooth decay may be due to wrong practices
during infant period

154. PROMOTING HEALTHY FAMILY FUNCTIONING:
Because learning self-confidence is the primary goal of a child
during the toddler period,
Help parents to understand their responses to these attemptsتلاواحم
at independence are crucial مهمto the healthy development of their
child.
Although the child still needs firm limits to feel secure, a child
must be given room to make independent decisions in areas the
parents feel they do not need to control.
At bedtime, naptime, or anytime they are tired, toddlers may
become much more like their old selves, wanting to sit on a
parent’s lap and be rocked or picked up and carried. This does not
signal babyish behavior or regression in a toddler; it is a natural
state between infant and preschool ages.

155. PARENTAL CONCERNS فواخمASSOCIATED WITH THE
TODDLER PERIOD
•1-Toilet Training:
•Toilet training is one of the biggest tasks a toddler tries to
achieve.
•You can explain to parents that toilet training is an
individualized task for each child.
•It should begin and be completed according to a child’s ability
to accomplish it, not according to a set schedule .
•Toilet training need not start this early, however, because
cognitively and socially, many children do not understand
what is being asked of them until they are 2 or even 3 years
old.

156. •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 by 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 enjoyment for a
more socially accepted action.

157. Myelinization of the spinal cord which usually occurs
between 12 to 18 months.
The average toddler is ready for toilet training to begin until 18
to 24 mo.
If the child resist it is helpful to stop training and wait 30 to 60
day and begin .
Bowel control is usually achieved before bladder control .
Daytime bladder control occurs before nighttime bladder
control.
Punishment and coercive يرهقtechniques cause feeling of
shame and lead to power struggles تاعارص.
Many children cannot remain completely dry until the age of 3
year .

158. Sign redness for toilet training

161. The markers of readiness for toilet training :
children are ready for toilet training when they begin to be
uncomfortable in wet diapers.
They demonstrate this by pulling or tuggingبحسat soiled
diapers,
or they may bring a parent a clean diaper after they have soiled
so they can be changed of autonomy.
child can remove own clothing
child is willing to let go of a toy when asked
كلذ هنم بلطُي امدنع ةبعل نع يلختلل دادعتسا ىلع لفطلا نوكي
child is able to sit , squat صفرقتيand walk well

162. RitualismسوقطAnd The Importance Of
Routine
Ritualism help the child venture رماغيout and away from the
safety of the parents by ensuring uniformity and security .
they also enjoy ritualistic سوقطpatterns. They will use only
“their” spoon at mealtime or only “their” blanket at bedtime..
They will not go outside unless a mother or father locates their
favorite cap.
Ritualism allow the toddler to have a sense of control, the
child feels more confident with a secure home base.

163. Negativism

164. Negativism :-
As part of establishing their identities as separate individuals,
toddlers typically go through a period of extreme negativism.
One of the most dramatic expressions of independence is show
in a variety of way the toddler favorite word seems to be no.
نم ةعونتم ةعومجم راهظإ وه للاقتسلاا نع ةيكيتامارد رثكلأا تاريبعتلا دحأ
يه راغصلا لافطلأا ىدل ةلضفملا ةملكلا اهب ودبت يتلا قرطلا"لا"
The toddler seems to feel that saying yes .
Negativism may result in screaming , kicking , hitting, biting,
or breath holding .
The nursing should given support and encourage the parent to
deal with the toddler trying behavior with patience and a sense
of humor,حازمto much pressure and forceful method of
control often lead to defiance tantrum بضغ ةبونand prolonged
negative

166. How to deal with negativism:
1-A toddler’s “no” can best be reduced by limiting the number
of questions asked of the child. A father does not really mean,
for example, “Are you ready for dinner?” He means, “Come to
the table. It’s dinnertime.
2-A toddler needs experience in making choices, It’s bath time
now” but then says, “Do you want to take your duck ةطبor
your toy boat into the tub with you?” Other example is “It’s
lunchtime. Do you want to use a big or little plate نحص?”.

168. Discipline:بيدأت
Discipline means setting rules or road signs so children know
what is expected of them.
Punishment is a consequence ةبقاعthat results from a
breakdown in discipline بيدأتor the child’s disregard of the
rules that were learned.
Discipline بيدأتfor the toddler should be designed to teach
rather than punish.
Two general rules to follow include:
1. Parents need to be consistent.نيقستم اونوكي نأ ءابلآا ىلع بجي
2. Rules are learned best if correct behavior is praised rather
than wrong behavior punished.

169. One goal of disciplineبيدأتand limit setting is to teach self-
control .
Toddler need and want discipline to feel secure ,they have little
control over their behavior and need limits to learn how to
behave and how to follow the rules and expectation of society.
Effective discipline techniques for children of this age include
a time out , diversion, and positive reinforcement, physical
punishment, such as spanking , is one of the least effective
discipline techniques.
،ةلهملا رمعلا اذه يف لافطلأل ةلاعفلا طابضنلاا تاينقت لمشت
برضلا لثم ،يدسجلا باقعلاو ،يباجيلإا زيزعتلاو ،ليوحتلاو ،
ةيلاعف لقلأا طابضنلاا تاينقت دحأ وه

170. Separation Anxiety
Separation anxiety is a fear of being separated from parents
begins at about 6 months of age and persists throughout the
preschool period.
Toddlers who have separation anxiety have difficulty
accepting being separated from their primary caregiver to
spend the day at a day care center or if they or their primary
caregiver is hospitalized
Separation Anxiety peaks`ةورذagain in the toddler period .
Children at this stage have difficulty differentiating their own
feeling from those of their parents , although the children
experience a strong desire to be independent and leave their
mother.
Leave taking and brief separation are acceptable to a toddler if
they are the toddler idea .

171. Games such as hide and seek ةضيمغلا لثم باعلأhelp the child
master fears of separation child can control.
Toddler should be told honestly and clearly about a separation
shortly before it occurs.
Transition objects such as favorite blanket or toy provide
comfort to the toddler .
Affection and attention are needed to help the toddler cope
with the stress of separation.

172. Temper tantrum for toddler

173. TEMPER TANTRUMS:بضغلا تابون
(uncontrolled anger reactions)
Almost every toddler has a temper tantrum at one time or another.
The child may kick; scream; stomp feet; shout, “No, no, no”; flail
arms and legs; bite; or bang his or her head against the floor.
Temper tantrums occur as a natural consequence of toddlers’
development.
temper tantrums occur most often when children are tired, just
before naptime or bedtime, or during a long shopping trip or visit.
parental practices such as inconsistency, permissiveness excessive
strictness a over protectiveness increase the probability of
tantrums.
ةطرفملا ةيامحلاو ،ةطرفملا ةمارصلاو ،حماستلاو ،قاستلاا مدع لثم ةيوبلأا تاسرامملا
بضغلا تابون ةيلامتحا نم ديزت
Some children hold their breath as part of a temper tantrum until
they become cyanotic.

174. suggestions for managing temper tantrums.:بضغلا تابون
1-Do assessment to determine the reason for tantrum
2-The best approach is for parents to simply tell a child that they
disapprove of the tantrum and then ignore it.
مث بضغلا ةبون ىلع قفاوي لا هنأ ةطاسبب لفطلا نادلاولا ربخي نأ وه بولسأ لضفأ
اهنلاهاجتي
3-Safety isolate and ignore the child.
4-The child should learn that nothing is gained from a
tantrum not even attention.

176. Sibling riveraly ءاقشلأا سفانت
Parent love and attention difficult for most toddler .
راغصلا لافطلأا مظعمل ةبسنلاب بعص رمأ مهمامتهاو نيدلاولا بح
Toddler egocentrism ةينانلأاmakes it difficult for them to
understand that a parent can love more than one child..
The toddler has limited resources to cope with such stress and
may react by treating the baby roughly damaging property or
harming pets .
ةلماعم للاخ نم لعافتي دقو طغضلا اذه لثم عم لماعتلل ةدودحم دراوم لفطلا ىدل
ساق لكشب ةفيللأا تاناويحلا ءاذيإ وأ تاكلتمملا فلاتإب لفطلا

177. Sibling rivalry

178. Strategies to Decrease Sibling Rivalry
-Including the toddler in preparation for the new baby .
-Explaining to the toddler what new babies are like .
-Letting the child feel the fetus move .
-Reading picture books about new sibling .
-Talking about changes that the newborn might create.
-Referring to the baby as ours.

179. How to deal with sibling rivalry keep under
supervision of parents

180. Characteristics of Preoperational
Thinking
–Egocentrism ;-ةينانلااviews everything in relation to
self is unable to consider another point of view.
–Animism :-believes that inert objects are alive
and have wills of their own .
–Irreversibility :-cannot see a process in reverse
order
–Magical thought :-believes that magical thought is
the cause of event.
–Centration :-tend to focus on only aspect of an
experience ignoring other possible alternatives.

181. Play :-
Four year tend to be more argumentative and less generous
with playmates, and feel more secure in a group and are testing
their roles and communication skills.
ءلامز عم ًءاخس لقأو ًلادج رثكأ اونوكي نأ ىلإ تاونس عبرلأا ووذ لافطلأا ليمي
تاراهمو مهراودأ نوربتخيو ةعومجملا يف ناملأا نم ديزمب نورعشيو ،بعللا
مهب ةصاخلا لصاوتلا.
The 5 year enjoys playing with other children .
Children between the age of 3 to 5 year enjoy parallel and
associative.ةيطبارتو ةيزاوم
During play preschooler learn simple games and rules ,
language concepts, and social roles.
Preschooler enjoy dress-up clothes , housekeeping, toys, doll
houses, and other toys that encourage pretending , tricycles
and climbing toys help to develop muscles and coordination.
preschooler also enjoy materials for cutting, pasting, and
painting.

182. Physiologic Anorexia:-
•Teach parent appropriate ways to approach the
child who is experiencing physiologic anorexia.
•Parent not to allow their child to fill up with
snacks, milk, and juices, small portion should be
offered so that the child does not feel
overwhelmed لقثُمby the amount of food , meal
time should be pleasant and not time to discuss
discipline بيدأتproblems , children should not be
made to sit at the table after the rest of the
family has left.

183. Preventing Poisoning :-
Children younger than 5 year are the most common victims of
poisoning and children 1 to 3 year are at the highest risk.
Small children who are thirsty or hungry will ingest poisons
that look or smell inviting .
Medication should never be called candy تايولحand because
young children often mimic their parent, adults should be
discouraged from taking medicine in the child's presence.

184. Preschooler Safety
car safety
Fire and Burn Safety
firearm safety :-many guns are kept in the home loaded and
readily accessible to young children
personal safety basic guideline that a child need to know
about personal safety include saying no, getting away and
telling an adult.
Children need to know how to access emergency help if they
need it
Children learn to identify safety officials نيلوؤسملاand how to
dial emergency numbers.

185. •Sexual Abuse
•Preventing sexual abuse begins with teaching
children the normal
healthy boundaries of their bodies and what
constitutes inappropriate Behavior .
•If some one is touching their body in an
inappropriate way , they should Always tell an adult.

186. •Physical readiness

187. •Selected Issues Related to the Preschooler
Stuttering
ةأتأت ةسردملا لبق ام ةلحرمب قلعتت ةراتخم اياضق
•Is a disturbance in the flow and time patterning of
speech. This may include repeating words or
phrases
•Dysfluency ةقلاطلا للخtend to be more common during
time of excitement ةراثلإا.reaction to stuttering can
increase the dysfluency.ةقلاطلا للخ
•Child is expressing not on the way the child is
speaking, parent should not complete their child
sentences or draw attention to their child speech.

188. What are the different types of stuttering?ةأتأت
•Developmental stuttering
As their speech and language processes are developing,
they may not be able to meet verbal demands.
•Neurogenic stuttering
Neurogenic stuttering is also a common disorder that
occurs from signal problems between the brain and
nerves and muscles.
•Psychogenic stuttering
This type of stuttering may occur in people with a mental
illness, or those who have experienced excessive mental
stress or anguish.ةاناعمAlthough stuttering may cause
emotional problems, it is not believed to be the result of
emotional problems.

189. •How to Help the Child Who Stutters
•listen closely when your child soeaks.ثدحتي
•Speak slowly
•Provide opportunities for the child to talk
without distraction
•Reduce pressure to communicate by limiting
the number of question.
•Do not ask a second question before the first
question is answered.
•Repeat or rephrase what your child says to
verify that you have understood it.

190. •Preparing the Child for school
•Child physical health and strong .
•Child attends to own toileting need and washes hand
independently .
•Child can separate from parent
•Child attention span is long
•Child can listen to and follow tow or three part instruction
•Child can restrict talking to appropriate time
•Child is able to tolerate the frustrationطابحإof not receiving
immediate attention from the teacher.
•Child can hold a pencil properly and turn pages one at a time
•Child counts 10
•Child recognizes the colors of the rainbow.حزق سوق