Health promotion of the Toddler and family Promoting optimum growth and development By: Dr. Omayyah Nassar https://www.google.jo/search?q=Toddler+children+pictures&source=lnms&tbm=isch&sa=X&ved=0ahUKEwju_I-W2q_XAhXRjKQKHZWWCTUQ_AUICigB&biw=1366&bih=662#imgrc=JzVl1FZXcd5kaM:

Objectives By the end of this discussion the student will be able to: 1- Identify the major biologic, psychosocial, cognitive development during toddler years Discuss language development during toddler period

Introduction The term terrible has often been used to describe the toddler years, the period from 12 to 36 months of age It is a time of intense exploration of the environment as children attempt to find out how things work and how to control others through temper tantrums, negativism, and obstinacy.. (عناد) https://www.google.jo/search?q=Toddler+children+pictures&source=lnms&tbm=isch&sa=X&ved=0ahUKEwju_I-W2q_XAhXRjKQKHZWWCTUQ_AUICigB&biw=1366&bih=662#imgrc=JzVl1FZXcd5kaM:

Introduction Although this can be a challenging time for parents and child as each learns to know the other better, it is an extremely important period for developmental achievement and intellectual growth https://www.google.jo/search?q=Toddler+children+pictures&source=lnms&tbm=isch&sa=X&ved=0ahUKEwju_I-W2q_XAhXRjKQKHZWWCTUQ_AUICigB&biw=1366&bih=662#imgrc=oTymHQ6dW-pTVM:

Biologic Development Toddlerhood – 13 to 36 months (1-3 years) Physical Development Weight gain = 1.8-2.7 kg /yr.4 times of birth weight. Birth weight quadruples by 2½ years

BIOLOGIC DEVELOPMENT Height is increased 7.5 cm/yr. occurs mainly in elongation of the legs rather than the trunk. In general, adult height is about twice the 2-year-old child's height.

BIOLOGIC DEVELOPMENT Height is increased 7.5 cm/yr. occurs mainly in elongation of the legs rather than the trunk. In general, adult height is about twice the 2-year-old child's height. ttps://www.google.jo/search?q=length+of+toddlers&source=lnms&tbm=isch&sa=X&ved=0ahUKEwiL17naqbfXAhUSCewKHdyNBaAQ_AUICigB&biw=1366&bih=662#imgrc=qB-9AkdC5hG1TM:

BIOLOGIC DEVELOPMENT Accurate measurement of height and weight during the toddler years should reveal a steady growth curve that is step like in nature rather than linear (straight), which is characteristic of the growth spurts during the early childhood years.

Biologic DEVELOPMENT Head circumference increase during the second year is 2.5 cm. Then the rate of increase slows until at age 5 years the increase less than 1.25 cm per year The anterior fontanel closes between 12-18 months of age. Chest circumference (CC) continues to increase in size and exceeds HC .

Biologic Development CC shape changes as the lateral (transverse) diameter exceeds the anteroposterior diameter. After the second year the CC exceeds the abdominal measurement.

Sensory development: Visual acuity is fairly well established at 1 year. at 2years visual acuity is 20/40 Accommodation to near and far objects is fairly well developed by 18 months and continues to mature with age

Sensory development Hearing in the 3-years-old is at adult levels. * The taste buds of the toddler are sensitive to the natural flavors of food. * Touch is a very important sense and a distressed toddler is often soothed by tactile sensations.

Sensory development Depth perception continues to develop but, because of the child's lack of motor coordination, falls from heights continue to be a persistent danger. Development of specific taste preferences. The child is much less likely than infants to try a new food because of its appearance or smell, not just its taste.

Maturation of systems Most of the physiologic systems are relatively mature by the end of toddlerhood. Volume of the respiratory tract and growth of associated structures continue to increase during early childhood, lessening some of the factors that predisposed the child to frequent and serious infections during infancy.

Maturation of systems The internal structures of the ear and throat continue to be short and straight, and the lymphoid tissue of the tonsils and adenoids continues to be large As a result, otitis media, tonsillitis, and upper respiratory tract infections are common The respiratory and heart rates slow, and the blood pressure increases Respirations continue to be abdominal.

Maturation of systems The digestive processes are fairly complete by the beginning of toddlerhood The acidity of the gastric contents continues to increase and has a protective function, since it is capable of destroying many types of bacteria Stomach capacity increases to allow for the usual schedule of three meals a day. https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=2VgHWr74GYKdsAeBi5zoAw&q=nutriton+of+toddlers&oq=nutriton+of+toddlers&gs_l=psy-ab.12...271836.277899.0.284040.16.13.0.0.0.0.212.1659.0j9j1.10.0....0...1.1.64.psy-ab..6.4.703...0i7i30k1j0i8i30k1j0i8i7i30k1j0i19k1j0i8i13i30i19k1j0i8i13i30k1.0.aNNCaHUIi0A#imgdii=qmntzXogF1Ur0M:&imgrc=IFJWtlVaW9F5bM:

Maturation of systems One of the more prominent changes of the gastrointestinal system is the voluntary control of elimination. The physiologic ability to control the sphincters probably occurs somewhere between ages 18 and 24 months.

Maturation of systems Bladder capacity also increases considerably. By 14 to 18 months of age the child is able to retain urine for up to 2 hours or longer. https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=LVoHWuX0DtDEkgXx4qKgBQ&q=Urinary+habits++of+toddlers&oq=Urinary+habits++of+toddlers&gs_l=psy-ab.3...130782.138767.0.141306.23.20.0.0.0.0.854.3382.0j6j5j5-1j1.13.0....0...1.1.64.psy-ab..10.2.1390...0i8i7i30k1j0i7i30k1j0i8i30k1.0.seAR_-n_sFc#imgrc=K6hicisqNYNWcM:

Maturation of systems The defense mechanisms of the skin and blood, particularly phagocytosis, are much more efficient in toddlers than in infants. The production of antibodies is well established. Many young children demonstrate a sudden increase in colds and minor infections when they enter preschool or other group situations, such as day care, because of their exposure to pathogens.

Maturation of systems: Rapid growth in neurobehavioral organization contributes to greater regularity of sleep-wake cycles, the diminishing of crying and unexplained fussiness, and the enhanced predictability in mood. Valuable stimulants of early brain development include the various interactions (talking, singing, and playing) between the toddler and caregivers.

Fine Motor Development By age 12 months toddlers are able to grasp a very small object but are unable to release it at will. At 15 months they can drop a pellet into a narrow-necked bottle. https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=u1oHWrDpIJDQkwWmuKOgDw&q=fine+motor+development+++of+toddlers&oq=fine+motor+development+++of+toddlers&gs_l=psy-ab.3...241807.255725.0.257494.37.31.0.0.0.0.589.5214.0j20j1j3j1j1.26.0....0...1.1.64.psy-ab..12.3.471...0i7i30k1j0i8i30k1j0i8i7i30k1.0.HikcfTbLbbc#imgrc=uM9jmJg2BwhFaM:

At 15 months they can drop a pellet into a narrow-necked bottle. Casting or throwing objects and retrieving them become almost obsessive activities at about 15 months. Holds two cubes in one hand Scribble spontaneously Use cup well but rotate spoon before it reaches mouth https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=u1oHWrDpIJDQkwWmuKOgDw&q=fine+motor+development+++of+toddlers&oq=fine+motor+development+++of+toddlers&gs_l=psy-ab.3...241807.255725.0.257494.37.31.0.0.0.0.589.5214.0j20j1j3j1j1.26.0....0...1.1.64.psy-ab..12.3.471...0i7i30k1j0i8i30k1j0i8i7i30k1.0.HikcfTbLbbc#imgrc=uM9jmJg2BwhFaM:

Fine Motor Development By 18 months of age toddlers can throw a ball overhand without losing their balance. Built tower of three or four cubes Release, prehension and reach well developed In drawing, makes strokes imitatively Manage spoon without rotation

Fine Motor Development By age of 24: Build towers of six or seven cubes Align two or more cubes like train https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=u1oHWrDpIJDQkwWmuKOgDw&q=fine+motor+development+++of+toddlers&oq=fine+motor+development+++of+toddlers&gs_l=psy-ab.3...241807.255725.0.257494.37.31.0.0.0.0.589.5214.0j20j1j3j1j1.26.0....0...1.1.64.psy-ab..12.3.471...0i7i30k1j0i8i30k1j0i8i7i30k1.0.HikcfTbLbbc#imgrc=uM9jmJg2BwhFaM:

Fine Motor Development By age of 24: Turn pages of book one at a time In drawing, imitates vertical and circular strokes Turns doorknob, unscrew lid https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=u1oHWrDpIJDQkwWmuKOgDw&q=fine+motor+development+++of+toddlers&oq=fine+motor+development+++of+toddlers&gs_l=psy-ab.3...241807.255725.0.257494.37.31.0.0.0.0.589.5214.0j20j1j3j1j1.26.0....0...1.1.64.psy-ab..12.3.471...0i7i30k1j0i8i30k1j0i8i7i30k1.0.HikcfTbLbbc#imgrc=uM9jmJg2BwhFaM:

Fine Motor Development Age 30 months: Build towers of eight cubes Good hand finger coordination, hold crayon with fingers rather than fist In drawing, imitate vertical and horizental strokes.

Gross Motor Development The major gross motor skill during the toddler years is the development of locomotion Mastery of gross and fine motor skills is evident THROUGH child's activity such as play, dressing, language comprehension, response to discipline, social interaction, and propensity for injuries. The possibilities of the exploration, investigation, and manipulation of the environment—and its hazards—are endless.

Gross motor development Gross motor skill : By the 12-13 months of age toddlers walk alone using a wide stance for extra balance https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=vlsHWoHlAZCwsAfE4oWIDg&q=gross+motor+development+++of+toddlers&oq=gross+motor+development+++of+toddlers&gs_l=psy-ab.3...1133534.1138352.0.1139883.11.11.0.0.0.0.672.1430.2-3j5-1.4.0....0...1.1.64.psy-ab..7.0.0....0.hheAUbYDEc0#imgrc=ATULSfqNd4qGeM:

Gross motor development By age 15 months Creep up stairs Kneels without support Run clumsily; falls often https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=vlsHWoHlAZCwsAfE4oWIDg&q=gross+motor+development+++of+toddlers&oq=gross+motor+development+++of+toddlers&gs_l=psy-ab.3...1133534.1138352.0.1139883.11.11.0.0.0.0.672.1430.2-3j5-1.4.0....0...1.1.64.psy-ab..7.0.0....0.hheAUbYDEc0#imgrc=ATULSfqNd4qGeM:

Gross motor development By age 18 months: Assumes standing position Walks upstairs with one hand held Pulls and pushes toys Seats self on chair Throws ball overhand without falling https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=vlsHWoHlAZCwsAfE4oWIDg&q=gross+motor+development+++of+toddlers&oq=gross+motor+development+++of+toddlers&gs_l=psy-ab.3...1133534.1138352.0.1139883.11.11.0.0.0.0.672.1430.2-3j5-1.4.0....0...1.1.64.psy-ab..7.0.0....0.hheAUbYDEc0#imgrc=ATULSfqNd4qGeM:

Gross motor development By age 24 months: Goes up and down stairs alone with two feet on each step Runs fairly well with wide stance Picks up objects without falling Kicks ball forward without over balancing https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=vlsHWoHlAZCwsAfE4oWIDg&q=gross+motor+development+++of+toddlers&oq=gross+motor+development+++of+toddlers&gs_l=psy-ab.3...1133534.1138352.0.1139883.11.11.0.0.0.0.672.1430.2-3j5-1.4.0....0...1.1.64.psy-ab..7.0.0....0.hheAUbYDEc0#imgrc=ATULSfqNd4qGeM:

Gross motor development Jump with both feet Jump from chair or step Stand on one foot momentarily Takes a few steps on tiptoe

Psychosocial Development If the need for basic trust has been satisfied, the toddler child is ready to give up dependence for control, independence, and autonomy . They differentiation of self from others, particularly the mother. Differentiation of self from others particularly the mother Toleration of separation from parent. Ability to withstand delayed gratification.

psychosocial Development Control over bodily functions. Acquisition of socially acceptable behavior. Verbal means of communication. Ability to interact with others in a less egocentric manner.

Developing a Sense of Autonomy (Erikson) The developmental task of toddlerhood is acquiring a sense of autonomy while overcoming a sense of doubt and shame. As infants gain trust in the predictability and reliability of their parents, environment, and interaction with others, they begin to discover that their behavior is their own and that it has a predictable, reliable effect on others.

Developing a Sense of Autonomy (Erikson) Several characteristics, especially negativism and ritualism, are typical of toddlers in their quest for autonomy. As toddlers attempt to express their will, they often act with negativism, the persistent negative response to requests.

Developing a Sense of Autonomy (Erikson) The words "no" or "me do" can be the sole vocabulary. Emotions become very strongly expressed, usually in rapid mood swings. https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=M2AHWt7gA9KTkwWAuYGYDw&q=negativism++of+toddlers&oq=negativism++of+toddlers&gs_l=psy-ab.3...281789.289418.0.291450.36.21.0.0.0.0.457.3361.0j7j4j1j2.14.0....0...1.1.64.psy-ab..24.1.380...0i7i30k1j0i8i30k1.0.kwWTFNTZ3mc#imgrc=02kmfhy5N6zfAM: 37

Developing a Sense of Autonomy (Erikson) Ritualism, the need to maintain sameness and reliability, provides a sense of comfort. Toddlers can venture out with security when they know that familiar people, places, and routines still exist. https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=x2IHWvWOFpLPkgXOsofYCw&q=routin++of+toddlers&oq=routin++of+toddlers&gs_l=psy-ab.3...26076.30275.0.31531.17.12.1.0.0.0.239.1662.0j7j2.9.0....0...1.1.64.psy-ab..7.4.584...0i7i30k1j0i8i7i30k1j0i8i30k1.0.VaJZiLyD16c#imgrc=wpvjdtobuhZA4M:

Developing a Sense of Autonomy (Erikson) One can easily understand why change, such as hospitalization, represents such a threat to these children. Without the comfortable rituals, there is little opportunity to exert autonomy. Consequently, dependency and regression occur

Cognitive Development Sensorimotor and Preconceptual Phase (Piaget) The period from 12 to 24 months of age is a continuation of the final two stages of the sensorimotor phase. During this time the cognitive processes develop rapidly and at times seem similar to those of mature thinking.

Cognitive Development Reasoning skills are still quite primitive and need to be understood to effectively deal with the typical behaviors of a child of this age.

Invention of New Means Through Mental Combinations. From ages 19 to 24 months the child is in the final sensorimotor stage. During this stage the child is prepared for the more complex mental operations that occur during the phase of preoperational thought

Invention of New Means Through Mental Combinations. One of the most dramatic achievements of this stage is in the area of object permanence. Children will now actively search for an object in several potential hiding places

Invention of New Means Through Mental Combinations. Imitation displays deeper meaning and understanding. There is greater symbolization to imitation. The child is acutely aware of others' actions and attempts to copy them in gestures and in words.

Invention of New Means Through Mental Combinations Domestic mimicry: (imitating household activities) and sex-role behavior become increasingly common during this period and during the second year. https://www.google.jo/search?biw=1366&bih=662&tbm=isch&sa=1&ei=6WIHWuC8FMz5kwXQ663oBQ&q=Domestic+mimicry%3A++of+toddlers&oq=Domestic+mimicry%3A++of+toddlers&gs_l=psy-ab.3...174386.179038.0.181592.8.5.0.0.0.0.252.733.2-3.3.0....0...1.1j2.64.psy-ab..5.1.248...0i7i30k1j0i8i30k1.0.5EjGhnIXP2Y

Invention of New Means Through Mental Combinations Identification with the parent of the same sex becomes apparent by the second year and represents the child's intellectual ability to differentiate different models of behavior and to imitate them appropriately

Social Development A major task of the toddler period is differentiation of self from significant others, usually the mother Toddlers have an increased understanding and awareness of object permanence and some ability to withstand delayed gratification and tolerate moderate frustration.

Social Development They have learned from experience that parents exist when physically absent. Repetition of events such as going to bed without the parents but waking to find them there again reinforces the reliability of such brief separations

Language development Age 15 months: Mostly expressive jargon Understands better than communicates Understands simple commands Ask for objects by pointing Says four to six wards

Language development By age 18 months: Forms gesture-ward combination (points while naming) . Says 10 or more words. Points to common object such as ball Point to two or three body parts

Language development: By age 24 months: Knows about 300 words. Verbalizes need for toileting, food, drink. Use two- or three –ward phrases. Give first and last name Uses pronouns, I , me, you

Language development By age 30 months: Names one color Gives first and last name Uses plurals

Spiritual and Moral Development According to Fowler: They have only a vague idea of God and religious teaching. They begin to assimilate (understand) behaviors. According to Kohlberg ,children begin to know that some activities elicit affection and approval .

Development of body image Children learn to develop a sense of self-concept through their immediate social environment.. If children's social interaction with their parents are negative( disapproval regarding eating , toilet training) the children begin to see themselves as bad lead to negative self concept.

Development of body image With a healthy sense of self-esteem and security, the toddler is able to deal with periodic failures later in life without damage to self-esteem.

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