Period of intense exploration of the environment.

Wants to know how things work and tries to control others.

Short legs and a pot belly (lack of muscle tone).

Legs are bowed because they must support trunk.

Growth slows down.

Will have growth spurts.

Growth chart will be in a step-like fashion.

Will go through periods of eating a lot to not eating much at all.

Average weight gain is 5-10 pounds/year.

At 2 ½ years, should have quadrupled birth weight.

Height gain of 3"/year.

At end of 3^rd year, most of height is in legs.

By 2, chest circumference is larger than head.

Chest gets wider transversely.

Transverse diameter will exceed a/p diameter.

Vitals: pulse = 80-120, resps = 20-40.

Toddler is usually farsighted, clearest is 6 feet.

Books should have large pictures.

Hearing is acute and will use all senses to explore environment.

Between ages 1-3, eating problems appear for a number of reasons.

1. Growth rate has slowed, want and need less food than before which is normal.
2. Independence and autonomy, will ask for something to eat.
3. Appetite varies and will often want one kind = food jags.

How to minimize these problems: Nutritious meals should be planned.

Will eat what they need.

Want the same place at the table with same plate and cup.

Ignore dawdling, unless it gets unreasonable.

Have a calm down period before meal time.

Expect them to be messy.

This gradually diminishes as child gains skills.

15 months:

Can sit thru meals.

Prefers finger feeding.

Prefers to self feed.

Tries to use a spoon, but spills it.

Grasps cup with thumb and forefinger.

Tilts cup instead of head.

18 months:

Appetite decreases.

Improved control of spoon.

Puts spilled food back on spoon.

Holds cup with both hands, spills less often.

Throw cup when finished.

24 months:

Appetite fair to moderate.

Clearly defined likes, dislikes and food jags.

Grasps spoon between thumb and forefinger.

Accepts no help.

30 months:

Refusals and preferences are less evident.

Some hold spoon and cup like adult.

Tilts head to drink from cup.

Realized to control others by using the word "no".

Thru their behavior, they can control you.

They don’t have the language skills to communicate their frustrations.

Can’t comment on behavior, but praise when they gain control.

Give 2 acceptable choices.

Reasoning, scolding or punishing during a tantrum is useless.

Won’t be ready until they have sphincter control at 18 – 24 months.

By the time they are walking, will have sphincter control.

First control is bowel.

Note when normal BM’s are so you can know when to put them on the pot.

Between 2-3 control is bladder.

May not have complete control of bladder until 3-5.

Get potty chair to start.

Put them on it in front of the TV to get used to it, then put it in the bathroom.

For bladder, teach boys to aim at something in the toilet.

Egocentric – everything is "mine".

Pre-operations thought.

Imitators.

Symbolic play – can actually participate in something even though it’s not real.

No concept of quantity.

Can often regress.

Terrible two’s.

First words said at this age.

Helps autonomy.

Sense of power by saying "no" and "mine".

300 word vocabulary.

One or two word sentences.

ID’s body parts and what they do.

By 3 can count to 10.

They take language literally.

Feelings get hurt easily.

Find intrusive experiences very frightening.

Looking in ears and mouths should be done last.

Mimics our speech at this time.

Read chart.

Know MMR is usually at 15 months.

Moves from solitary to parallel play.

Will play alongside, but not with another child.

Imitates people around them.

Gross motor skills: push-pull, large books and balls.

Fine motor skills: large crayons and wood puzzles.

Check toys for safety.

Enjoys to play like cooking.

Discipline à to train to produce a particular behavior pattern.

Punishment à penalizing for a wrong doing.

3 types of discipline:

1. Consistency and timingà

• adults should all operate by same rules
• use messages that do not label the child as bad but label the act as unaccpetable

1. Time out à

• be alone but observed and without any distractions
• 1 minute/year of age is adequate
• one warning beforehand
• praise children for good behavior and when possible, ignore negative

1. Extinction à

• ignore as long as behavior is not harmful
• act as though you don’t hear the child

Spanking usually does not work well because child is taught hitting is acceptable and frequently becomes immune to it.

Leading cause of death in ages 1-4.

Accidents include MVA, drowning, burns, poisoning.

Poisoning is most common accident in ages 1-4.

Ages 3-6.

3 likes to please = pleasing threes.

4 = frustrating fours.

5 = fascinating fives.

3:

Potbelly begins to go away.

Growth occurs in legs and feet.

Looks long and slender.

Agile and graceful.

Good posture.

Gain 3-5 pounds/year.

Grow 2 ½" in height/year.

Now have all baby teeth.

When around 6, start to lose teeth.

Initiative vs. Guilt.

Play, work and live to the fullest.

Period of energetic learning.

Sense of accomplishment and satisfaction.

Encourage to be creative.

Give opportunities to explore different people and things.

Made to feel guilty when they overstep what they are able to do.

Begins to develop a conscience.

Begin to like parent of opposite sex.

Oedipus complex = boy likes mom.

Electra complex = girl likes father.

These are competition with same sex parent.

This helps establish sexual identity.

Love/hate relationship happen also.

Often they have a wish for the same sex parent to leave or be dead.

Should this actually happen by accident, the child believes he caused it.

Difficult time distinguishing real from fantasy.

They believe rules are fixed and they are absolute.

They believe rules are passed down by their all knowing parents – omnipetent.

Preoperational thought.

Will begin to share.

May have imaginary playmate.

Do not substitute punishment onto the playmate.

Usually occurs in children with no siblings.

Be sure to document on chart.

Likes to play dress up.

Like to do things they know about such as, mom and dad, policeman, teachers and doctors.

Still thinks literally.

Play is associative play.

Goes from 1000 words to 3000 words.

Telegraphic speech à 3 to 4 word sentences will only include the most important words.

Can follow simple directions.

Stuttering à ask them to slow down and they will eventually grow out of it.

Masturbation à curious about their bodies. Feels good. Teach that it is not acceptable in public. Normal for children to masturbate.

Will need a booster prior to starting school.

Achieve full bowel and bladder control by this time.

A common fear is of the dark.

We need to acknowledge the fear.

Should visit daycares periodically.

Can give simple directions and they will follow them.