Nanny 15

GB NANNY CARE INSTITUTE PHAGWARA
4Chapter-1
Nany an introduction
Nanny an introduction
Nanny is someone who is employed by a family on either a live in or a live out
bears to take care of children. Or a nanny is someone who provides child care with
in the family setting and she is fully invested in child’s development and growth.
Or a nanny is care taker of child who takes place of mother.
Rale of Nanny
1. Love the procession so that child loves to spend the entire day with you.
2. Be enthusiastic and passionate.
3. Be loving and cater to the child’s need immediately.
4. Build a relation of trust with the child and parents.
5. Always stay positive and calm.
6. Be a second mother of the child.
7. Be responsible and confident.
8. Be creative and organized.
9. Should be able to plan activities.
10.Be safety conscious.
11.Be a role model.
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Duties of Nanny
Types of nanny
 Live in nanny-all time (24 hrs.)
 Nanny share-3-4kids.
 Night nanny-night time care.
 In home nanny-care in family setting
 Many-male nanny.
Tips to be great nanny

 A great nanny should be.
 Respectful and organized
 Self-motivated
 Always ready to handle an emergency
 Understanding child development
 Advocate for children
 Reserved of full energy and patience
 Safety conscious
 Flexible and reliable
 Trustworthy and responsible
 Committed to make positive difference
 Loving with company of children
Good behavior of Nanny

1. Do apologize whenever required.
2. Do congratulate the child on his/her achievements, even if you approve of
his/her ways.
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3. Use time effectively and appropriately.

4. Ask for feedback and take it positively as Reflection is key of professional
growth.
5. Keep your mobile mute during class hours and even otherwise no fancy ring
tones.
6. Be careful and polite in all type of communication.
7. Do reply every sums or Emails sent by the respective by the student or the
respective parents.
8. Always act with honest and dignity.
9. Dress proferrionally and present yourself in appropriate attire.
10.Attend all meetings and maintain punctuality.
11.Engage with respectful behavior during the child care.
12.Do not assume ask permission.
13.Say please, “thank you “, you’re welcome as part of your everyday courtesy.
14.Show appreciation for the slightest courtiers intended to you.
Activity – 1
What is nanny?
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A nanny is care taker of a child who takes place of mother.
Duties of nanny
Nanny helped the child in studies.
Nany creates an activity for children
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Nanny as a housekeeper cleaned the house.
Nanny takes care of a child or

Nanny as a nurse.
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Nanny helped the child in dance.
A nanny played with the child.
Nanny helped the child in the park.
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Nanny cooked the food for the child
Nanny drives the car for outing the child.
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Chapter -2
Qualities of Nanny
Qualities of Nanny
Sometime it’s hard to know the Qualities of nanny. The Quality of Nanny is the
Reflection of her good ride, when she is with the children on the work .There is not
much difference between a nanny and a mother. A nanny has to develop good
caring skills like a mother. Some of the Qualities are in listed below.
Loves the company of children

Nanny spend majority of the day with little adult interaction and truly in joy
spending their time with children.
Basic understanding of child development

Nannies are child care specialist and responsible for providing the children with
developmentally appropriate.
Advocate for the children

Nannies are willing to speak up for child interest, Behavior and their society.
Lot’s of energy
Nannies are responsible for actively in gaging the children in their and must have
energy to do so.
Reserve of Patience
Nannies spend countless hours with the children and must be able to handle
children mood and behavior without losing temper and irritate.
Good communicator
Nannies have to effectively relay and receive information from parents and
children, solid communication skills are required.
Flexibility
Nannies must be able to adapt to the situation they face.
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Understanding
Nannies are in the burners of caring for others compassion and understanding is
paramount. (Important)
Nurturing spirit
Nurturing are Responsible for sporting encouraging children and must be able to
foster their development.
Reliable
Parents are relying on nannies so that they can fulfill their obligation. Nannies
must be able to be counted on.
Trust worthy
Parents depend on nanny to meet exceed the terms of their working relationship.
Nannies are trusted to do their job will and to provide outstanding care.
Respectful
Nannies and parents may not always agree on child rearing practice or decision.
Nannies must be respect full of the parents and honor the authority they have.
Sound judgement
Nannies share the responsibility for the children’s health and development and
must be able to make choices that are in the children’s best in treat.
Organized
Nannies have many Responsibilities throughout the day and must re-organize to
ensure that they fulfill their duties and complete their task.
Self-motivated
Nannies don’t have someone constantly looking over shoulders afferent praise
prairie for a job well done. They must to motivate to always do their job to the
best of their abilities.
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Prepared to handle an emergency

Sometimes children get hurt and natural disaster and accidents happen nannies
must know how to handle on emergency if one were to arrive.
Creativity
Nannies must engage the minds of children in their care to work as a nanny
image.
Proactive
When it comes to discipline safety and meeting the children heed. Nannies must
be proactive rather than active.
Strong morals
Mannie’s help to shape a child’s world view and set their internal compass.it
should be evident that nannies know right from wrong nest be sound moral
character.
Connection with children

To develop bonds with the children in their care. Nannies must be able to connect
with children. Nannies naturally make connection with kids.
Positive difference
Nannies influence the children in their care and must commit to making a positive
difference in the lives of children.
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C HAPTER-3
C OMM
UNICATION
Communication
Communication is derived from Latin word communism which means common .It
Means communication and receiver have a common understanding of ideas,
thought discursion mirage and information which they are talking about.
It is a process through which we can mutually exchange our view moreover .It is
also a process of sharing information ideas and attitudes between individuals.
Purpose of communication
Flow of information
The relevant information must flow continuously from top to bottom and vice –
versa. The staff at all levels must be kept information about the organizational
objectives. A care should be taken that no one should be taken that no one should
be misinformed. The use of difficult words should be avoided. The right
information should reach the right person at right time through right person.
Co-ordination
It is through communication the efforts of all the staff working in the organization
can be co-ordinates for the accomplishment of the organizational goals. The co-
ordination of all personnel’s and their efforts is the essence of management which
can be attained though effective communication.
Learning Management skills
The communication facilities flow of information ideas beliefs perception advice,

opinion orders and instruction etc. both ways which enables the managers and
other supervise.
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Learning management skills

The communication facilities flow of information ideas, beliefs perception advice
opinion orders and instruction etc. both ways which enables the managers and
other supervise.
Preparing people to accept change

The proper and effective communication is an important tool in the hands of
management of any organization to bring about overall change in the
organizational policies procedure and workstyle and make the staff to accept and
respond positively.
Developing good human relation

Managers and workers and other staff exchange their ideas thoughts and
perception which with each other better. They realize the difficulties by their
colleagues at the work place. This leads to promotion of good human relation in
the organization.
Importance of communication
1. Bear for action
Starting of any activity begins with communication which brings information

necessary to begin with.
2. Means of coordination
Coordination the effects of various people at work in the organization.
3. Aids in decision making
It facilitates access to the vital information required to take decision.

4. Boosts morale and motivation
An effective communication skill instills confidence among subordinates.
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5. Palming becomes easy
6. Provides effective leadership
Prowers of communication
Or
S M C R
Communication Content Hearing Communication
Skills Skills
Attitude Element Seeing Attitude
sKnowledge Treatment Touching Knowledge
Social system Structure Tasting Social System

Culture Codes Reading Culture
Feed back
Sender Message Message Message Receiver
(In code) Channel (de code)
Feedback
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Explanation of Process
Sender
It is the sender who initiates the message (verbal/non-verbal)
Message
It is the information encodes by sender to the receiver.
Channel
It is the source by which sender horses’ message to receiver.
Receiver
It is the decoder who receives the message and interprets it.
Types of communication
It is of two types
VE RB AL NON-VERBAL
Oral Gestures
Visual Action
Written Postures
Other type of communication

One way, two ways, formal, informal visual, oral, tele.
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Barrier to communication
Physical e.g. Deaf ,dumb, blind
Perceptual e.g. Negative, thoughts
Emotional e.g. Crying, laughing
Cultural e.g. Religion, Cast
Language e.g. Foreign, language
Gender e.g. Male ,female

community
Wrong channel e.g. Disability
Lack of feedback e.g. Non response(reply)
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Methods to overcome Barrier

 Explanation sources
 Creativity
 Comfort
 Accept reality
 God oriented
Chapter-4
Non-Verbal communication
Non-Verbal communication
Non-Verbal communication- communication without words Non-Verbal

communication through sending and receiving worldlier message.
Methods of Non-Verbal communication
Closeness
Way of talking Posture
Facial
exprerrion Non-Verbal Appearance
communication
16 Head
Eye movement Movement
Hand movement
Hand
movement
Sound
Personal Appearance
Gesture
A gesture is a characteristic of non-verbal communication in which visible body
action communication particular message.
Posture
Posture is how you carry yourself tells a lot about you. How you walk sit stand or
hold your head not only indicates your current mood but also your personality in
general.
Example walking with your head down and avoiding eye contact with others may
indicate shiners.
Facial expression
Facial expression is the key characteristic of non-verbal communication. Your
facial expression can communicate happiness, sanders, anger, and fear.
Eye contact
Eye contact is key characteristics of non-verbal communication, which express
much without using a single word-eye contact, establish nature of relationship.
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Body language
Body language also reflect the characteristic of an individual a person having a
confident personality will carry confident body language whereas person who is
not confident his body language reflects weakness.
Positive body language

Positive body Language helps to convey our message in better way.
Negative body language

Negative body language takes away the attain of the speaker and makes the
listener stop listening.
Time language
It chronemics is the study of the use of time in non-verbal communication Time
language includes punctuality, willingness. To wait and interaction.
Silence
Silence serves important communicate function.
 Allows time to speaker to think.

 Prepare the receiver for the importance of future message.
 Used as a response to personal anxiety, shiners, threats.
 Used to prevent communications.
 Used to communicate emotional response.
Tips for improving non-verbal communication

 Avoiding giving conflicting signals.
 Try to be as honest as pourable in communicating your emotions.
 Smile genuinely.
 Maintain eye contact.
 Beware of your posture and gesture.
 Try to use appropriate vocal signals to minimize error in message.
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Good communication skill

 Making eye contact while communicating with people is important because
it shows you are listening to them.
 Not swearing and shouting because it can be intimidating.
 Not chewing gum while having a conversation with someone.
 Not texting while speaking to someone as it will make them to think you’re
ignorant.
 Always trying to speak clearly and use words everyone can understand.
 Make positive facial exprerrion.
 Listening to be person you are speaking to.
 Have a relaxed body language.
 Don’t speak over to other people.
 Keep to the point when explaining something.
Chapter-5
Management in Nanny care Business of Nanny
Management in Nanny care Business of Nanny

Families also want someone who is reliable. Parents wants to hire Nanny who take
care their jobs seriously nannies who act proferrionally from start to finish.
From finding Nanny Jobs to figuring out how much to charge. This chapter will
help to become a kind of s Nanny who is asked to babysit again and again.
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Getting started
Ask your parents

 Before beginning your career as a nanny talk to your parents.
 Give your parents the phone number and address for your nanny job .
 Inform your parents while or about all the detail of nanny job .
 Remind your parents while leaving the job so. They can know when to
expect you at home.
Assessing self-skills as a nanny

The next step to become a safe and successful nanny is assessing your nanny
skills. Just as science teachers are different from English teacher. Nanny differs
from one another.
For example
One nanny may be especially good at crafts while another nanny may have
experience taking care of infants. Every nanny job is different as well some jobs
may require special skill or extra experience such as nanny for infants, several
young children at the same time, children with special needs or when nanny at
night or for several hours. Do not accept jobs that are beyond your ability
Self-assessment tool
1. Special skills and ability
My Special ability include check all that apply
Music, Art and craft, good student, patience, creativity, storytelling, love kids,
sports, sense of human other
2. My leaderships and nanny skill include

Making good decision
1. Very good 2.Good 3.Needs work
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Problem solving
1. Very good 2.good 3.needs work
Staying calm in an emergency
Communicating well with children
Role modeling positive behavior

Recognizing and respecting difference

Correcting misbehavior appropriately

Recognizing and making consideration

Assuring nanny jobs and gathering the necerrary information before

they begin.
Acting proferrionally at all time.

3. My safety and fist did skills include.

Recognizing and removing or limiting safety related problem.
Supervision children at all time.
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Choosing appropriate toys and activities for children of different ages.

Recognizing and actin promptly in an emergency.
Giving appropriate care for children of different ages.

Check all the apply
1. Being certified in American Red Cross CPR-Child and infant
2. Being certified in American Red cross standard first aid.

4. My basic child care skills include
Diapering
Feeding children with a bottle or spoon.

Helping children get rest and sleep.

Picking up and holding children correctly

5. Preferences
I prefer to care for
1. One child at time 2.Infant 3.To idlers school age children.
The time of day I can nanny is

1. Moring 2.Afternoon3.evening.night
I absolute do not want to baby when
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6. Parents arraignment
My parents guardians will
1. Take me to and from jobs.
2. be available by phone when I am on the job.
3. Tell me which jobs they will not allow me to accepts
4. Tell me their rules for my nanny jobs.
5. Work with me to make sure that my nanny (jobs) first aid kit is fully supplied for
each nanny job.
7. My parents or guardians will not allow me to accept these jobs.
8. My parents or jobs rules for my nanny job.
Finding work
Under this following contents may occur.
Networking
One of the best ways to get nanny ask friends, relatives and neighbors if they
need a nanny or if they know someone else who does talk to other nannies and
offer to fill in as a substitute.
Business cards
They can be very helpful tool for building up. Your nanny business. You can make
your own business card. Ask friends, relatives, and neighbors to give your cards to
people. They know who might need a nanny.
Your Name here
Nanny /care provider
Phone no-(country code) contact no-
Alternative ph.no.(country code)
Contact no….
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Resume
Resume is another great tool for helping you get a nanny jobs’ resume is a brief
summary of your skills, Qualifications and experience along with some personal
information. You should have a resume ready to give to families interested in
hiring you as their nanny. Do not past your resume in public places.
Name
Address Email
Post code
Education
School study or educational achievement
Training (addition trading)

Additional Training
Institution name
Extra things you (where you have
learnt during doneNanny
course. your nanny care course)
experience. Mention the
address./no.of earlier plows where you worked at with details of your work.
Interviewing the family
Asserting the job and gathering information

Compare the job details with your nanny skill availability, expectations and
preferences as well as with the expectations of your parents because to meet the
children. You will be nanny. You should never take on a nanny job that exceeds
your abilities or one that you are uncomfortable with for any reason.
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A.The following points will help you arrears the job
1. Date
Find out the date of the job. Be sure to check your schedule for conflicts and your
parents before accepting any nanny jobs.
2. Trans potation
How will you get to and from the job never walk home alone at night.
3. Number of children
Do not offer to nanny for more children than you can safely handle.
4. Ages of children
In general younger children need more care. Nanny jobs where you are expected
to watch sever as young children (three or more) by yourself can be very
challenging.
5. Length of time
Hours make the job harder and may interfere with your homework, activities of
free time.
6.Time of day
Some parents stay out late, make sure you find out when they plan to be home.
7. Responsibility
Do not accept any additional Responsibility unless you are willing and can do
them safely.
8. House rules
Know the house rules for both yourself and the children.
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9. Children with special need

Some children with special need may use equipment like a wheel chair. Before
nanny a child with special need learn the specific duties, task and responsibility to
care for that child and determine if you care capable of meeting.
10. Pets
Find out if the fanny as any pets if they are friendly and if you are expected to
care for them.
B. Proferrional behavior
Family’s house holds rules and routines are acting in a Proferrional manual. (Show
families that you take your job seriously.
1. before the nanny job

Treat family is like customers .show them the the same respect and customers.
Show them the same respect and cutlery that you respect to be shown by them.
1. Check your availability before accepting the job.

2. Follow through on your work.
3. Never Nanny cares if you are sick.
4. Only cancel a nanny appointment for an emergency.
5. Alert the family in advance if you have to take the leave.
6. Darers in a clean comfortable clothes and bring an extra shirt along with
you in care of accident.
7. Only accept throe jobs for which you have right skills and experimental.
2. during the Nanny Job

1. Arrive at your job on time and slightly early.
2. Follow all of the family instructions and house hold rules.
3. Ask if you can use the phone.
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4. Wash your hands before preparing or eating food and after going to the wash
room, changing .dippers, cleaning and handling garbage.
5. Clean up after eating food.
6. Stay awake unless you are on overnight job.
7. Only use those items for which you have permission.do not allow your friend to
visit the home where you are working and do not smoke or use drugs or alcohol.
3. after the nanny job
1. Report to the parents when they return, note anything that occurs.
2. Never gripe about the family you working for, if you feel anything un
comfortable discuss it with the parents only.
3. Keep a diary or a record of each day of nanny job.
4. Add notes to up-date family information.
5. If you want to improve your nanny skills then always ask for feedback.
Chapter-6
Time management
Time management
Time doesn’t wait any of us. Only we can manage how use we our time by making
plans. Being organized or being plans. Being organized or being on time is useful
skills for anyone. The four skills work together to complete the time management.
1. Being on time
2. Taking initiative
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3. Listening to instruction
4. Organizing in task
It is important to show on time. Some of time children follow the routine the
routine, parents feel it is best for children if meals snacks rests happen around the
same time every day but each day brings new things to do. But we must use
“imitative “to decide how to fit those into the scheduke.We also need to listen
the instruction organized activities.
Being on time
A nanny should be punctual being on time is the way of showing respect to others
and expected to be treated with the same level of respect in return.
Initiative
To take action or make Decurion without waiting to someone else.
Listening to instruction
Listening to instruction and following them is a part of life and it helps to value the
rules and understanding the importance of rules.
Organizing task
Organizing task means that to balance the work properly. Good organization skills
can save the time of nanny.
A time management check list

A time management check list is a list with time which a nanny should do in a daily
routine. Every day a new check list should be run with the days, a proper record
should be maintain.
Daily Nanny duties check list
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Name Date-
Day-
Time Task
Notes Parents
signature
Nanny
Signature
For calculating min in hours
“x” hr. “x”x60(min)
For calculating sec.in min.
For calculating sec.in min.
“x” min “x”x60 sec.
For calculating min from sec
“X” sec (x/60) min.
For calculating hours from min.
“x” men (x/60)hour.
How to manage time
We should prepare correct time table to stay punctual. Following activity will help
us to learn time manage skills.
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Activity
Support you need to catch bus 8:20 at proper time.
Step-1 at the time needed for activities.
Activity Time in
minute
1. Getting up 10
2. Bath room 20
3. Dress 05
4. Prepare break fast 10
5. Eat 15
6. Clean up kitchen 05
7. Teeth /hair /makeup/shoes 10
8. To bus stop 05
9. Extra for unexpected 10
Total 90min
Step-2
Convert to hours. When the number of minutes in your prepared time to is more
than 60, we will shift to step2
90 min hour
X min (x/60) hr.
X 90
90 min (90/60) hr.
1.5 hours
One hour thirty mins.
One and half hours.
Step-3
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Count back words. You would not to catch 8:20 am bus. Why not plan to get their
5 minutes earlier that is 8:15 am .count back one hour from 8.15 am that is 7.15
am.again count back half an hour from 7:15 am that 6:45 am.we need to set our
alarm clock at 6:45 am.
 8:15 am_1 hour
=7:15 am
 7:15 am half an hour
=6:45 am
Prioritizing
Recognizing which things are urgent and must be done as soon as possible is
called prioritizing. As a nanny, it is very important to set priority according to child
need.
Chapter-7
Child growth and development
Child growth and development

Growth (Quantities change) an increase in size, length, height and weight is
known as growth.
Development (qualitative change) it is the different changes in quality and

character.
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Child growth and development is a complex process which is not only increase
growth but also increase maturity system, functioning.
Factors the influencing growth and development are
Internal factors
 Heredity
 Gender
External factors
 Nutrition
 Diseases environmental hazards season and climate.
Stages of life cycle

S.No Stages in life cycle Age
1 Prenatal period Conception birth
2 Neonate 0-1month
3 Infancy 1month -1year
4 Early child hood 2 year-6year
5 Middle childhood 6year-11year
6 Adolescence 11/12year-18/19year
7 Adulthood 19-year -40 year
8 Middle age 40year-60years
9 Old age 60year-above
Stages of growth and development in child-(0to18 year)

Prenatal
(Conception to birth)
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Nao natal
(0-1moth)
Infant
(1 moth -1 year)
Toddler
(1year-2/3year)
Pre-school child
(2/3 year -5 year)
School child
(5/6year-11year)
Teenage
(11/12year-18 year)
Pattern of development
Biological cognitive Social
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Biological
It involves the changes that are physical in nature.
For example growth of the body organs, hormonal changes at puberty.
Combinative
It involves changes in thinking intelligence and languages of child.
Social
It involves changing in the relationship of child with other people, motions and
personality.
Principles of growth and development
a. Continuity
Growth and development is a continue process from conception to death.
2. Scquenciality
All children follow a development and growth pattern in a sequence.
3. Differentially
Every child differs in the rate of growth and develops.
4. Gradual
Development is gradual. It doesn’t come all on sudden.
5. Predictable
The differences are physiological and psychological changes can be predicted by
the observation.
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Chapter-8
Developmental milestone
Developmental milestone
Developmental milestone are behaviors or physical skills seen in infants and
children as they grow and develop. Rolling over crawling, walking are some
examples of devilment miles tones. The development milestones of children
include following aspects.
1. Physical development
2. Motor
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3. Gross
4. Fine
5. Sensory development
6. Social development.
Ages stages and milestones in child

Stage Age Milestone
Neonate 0-1moth 28 1.Physical growth
days *Weight 2.5 kg, 10%decreases in the first 10 days
then it starts increasing 500-600 grams per month
for 6 months.
*Length 45-50c.m, It increases 2-2.5 p.m., per month
for 6moths.
*Head circumference33-35 cm, It increases 1.5 cm per
month for six months.
*Chest circumference It is about 31-33 cm.
*Pulse rate Pulse rate is 130+20/minute.
*Respiration Respiration is 35+10 minute.
*Blood pressure Blood pressure is 18/50+20/10 mm
hg.
*Reflexes The baby has well developed, sucking,
rooting, and swallowing.
2. Motor development
A.Gross motor
Head lags behind when paltry is pulled up from
supine to sitting position.
B. Fine motor
*Grasp reflex is strong.
*Baby can grasp an abject placed in hand but drops
it mime deathly.
3. Sensory development
*Protective blinking reflex is present.
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4. Language development
*Crying
*Makes comfort sounds.
Infant 1 moth to Physical development

1year
2nd moth *Tear start appearing
3rd moth *flexion posture is reduced.
4th moth *drooling indicates appearance of saliva.

*weight almost double of birth weight.
5th moth *Can breathe through mouth when nose is

abstracted.
6th moth *Teeth eruption starts with lower two central

teeth’s.
7th moth *mashes food with jaw.
8th moth *Eruption of upper central teeth’s.
9th moth
*eruption of upper lateral teeth’s.
10th moth
*drooling stops.
11th moth
*Sleeps 14-16 hours per day and still naps.
th
12 moth *weight becomes triple of birth weight.
(2)-Motor development
2nd month A. Gross motor
3rd moth
*lifts head almost to 45 above flat surface when
lying prone.
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*Above to lift head to 90 when in prone position.

4th moth
5th moth *Sit for short time with adequate support.

*Sits with slight support.
6th moth
*Pulls feet up to mouth when in supine
7th moth
*Early stepping movements.
8th moth
*pulls to standing position with help.
th
9 moth
*sits down
*Drinks from cup with help.
10th moth *Holds own bottle.
*walking skill development continues
*Doesn’t want to lie down unless sleepy.
*Makes stepping movements forward when two
11th moth
hands are held.
12th moth *Walks holding on to furniture.
*Pushes toys.
(B)
2nd moth *Stands alone for variable length of time.

*Few steps with help or alone.
3rd moth Fine motor
*Hands may be open
th
4 moth
*Can grasp a toy but lacks firm hold.
*Carries objects and hands to mouth at will.
5th moth Brings hand together in middle and plays with
fingers.
6th moth
*Can hold one object while looking at another.

th
7 moth
*Can grasp at will
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*Begins to transfer objects from one hand to

another.
8th moth
*Holds two toys together.
9th moth *Feeds self with finger foods.

*Drinks from cup with help.
10th moth *Holds bottle and places nipple in mouth when

11th moth wants it.
12th moth
*Brings hands together and plays.
*Removes covers from boxes and takes toys out of

nd
2 moth box.
3rd moth
4th moth *Enjoys eating with fingers.

5th moth (3) Sensory development
6th moth *Turns head to side when sound occurs at ear level.
*Blinks at objects that threaten the eyes.
7th moth
8th moth *Fairly good binocular vision.
9th moth *stops crying in response to music
10thmoth *Moues in order to see an object
11thmoth *Has preference in taste for food.
12thmoth *Depth perception is beginning to develop.

*Head turns directly to source of sound
*Tilts head backward to see up.

2ndmonth
39
*Can follow rapidly moving objects.
3rd moth *follow fast moving objects with eyes.
4th moth (4)Language development
*laugh and squeals

*Utter single vowel sounds such as, an and eh.
5th moth
*cries less
6th moth *Utters two syllable vowel sounds.
7th moth *Can vocalize consents like “m,b,g”.
*Responds to his/her name.

th
8 moth *Cries on seeing strangers.
*Vocalizes mono syllable like ma, da, be.
*Recognizes familiar words.
9th moth *Recognizes own name.
*Vocalizes “baba”dada.
10thmoth
*Begin to understand meaning of “no”.
11thmoth *Continues syllable “dada”, Mama” without specific
meaning.
12thmoth
*stops activity in response to “no”.
*says “dada” ”mama “with meaning.
*Comprehend ds “bye-bye”.
2nd moth *Responds to simple Questions.
*Understands simple directions.
*Comprehends”give”and stop when told “no”.
3rd moth (5) Social development
4th moth
*Smiles to mother/ Care giver.
5th moth
*Knows that cry will bring attention.
6th moth
*Looks in direction of speak.
40
7th moth *Initial social play by smiling.
*Smiles to self in mirror.

8th moth *Recognizes parents.
*Closes lips tightly when disliked food is offered.
9th moth
*Fear of strangers.
*Separation anxiety develops.
*Dislikes face wash

th
10 moth *cries when scolded.
*Wants to Please caregiver.
11thmoth
*Play social games with adults.
12thmoth
*Reacts to restriction with frustration.
*Responds to request for affection such as kissing.
41
15 moths *Turn pages

*Holds cup
*Removes socks
18 moths *Can eat with spoon.
*Plays with food.
24 moths *Picks up objects from floor.
*Drinks with glass.
30 moths *Places simple shapes in correct
holes.
Toddler 1 year to 3 years (1)Physical development
15 moths * Legs appear bowed
18 moths *10-14 deciduous teeth present.
24 moths *Has 16 Temporary teeth

* Weight gain is 1-8-2.7kg
*Pulse rate is 110+20 minute
*Respiration is 26 to 28/min.
*Blood pressure is 100/65+25/20 mm hg.
30 moths *Average weight is 13kg.
(b) Fine Motor
42
(3) Language Development
15 moth *Recognizes names of body parts.

*Says 2-6 Words.
18 moth *use gestures more than words to

make need known.
24 moth *Enjoys story

*Refers to self by name.
30 moth *Knows at least five body parts.
(4)Social development
15 month *Hugs and kiers

*imitates parents.
18 month *10-14, deciduous teeth present.
*imitates adult roles. (1)Physical
development (Preschool
24 month *Enjoys play with doll. Child)
3 years to 6 *Physical growth is relatively slow. They
years
30 moth becometemper
*shows tall andtantrums.
thin without gaining much
3 Years weight.
*Walks erect, swings arms.
4Years *Growth is low
43
5Years *Teeth decay may be present
6years *Average weight is 29 kg.
(2) Motor development

3years (a) Gross Motor
*Hops on one foot

*Rides tricycle.
*Catches soft object with both.
4 years
*Dresses without supervision.
5 years
*Throws and catches ball well.
6 years Rides bicycle with training wheels.
(b)Fine Motor
3 years *can build tower of 9-10 cubes.

*Brushes teeth with help.
4 years *Cuts pictures with scissors.
5 years *Copies a square, triangle and diamond shape.
6 years *Improved hand and eye coordination.
*Can brush teeth
*8Comb hair
44
*Dresses self.
(3) Cognitive development

3 years *Able to follow directional command.
4 years *Obeys commands because of parents fear and

not because of understanding between right and
wrong.
5 years
*Accurately describes events.
6 years
*Follow commands.
(4) Language development

3years *Ask many Questions.*Name body parts.
4 years *Questions is at peak.*knows nursery shyness
and simple songs.
5 years *uses sentences of 4-6 words with all parts of
speech.
6years *Counts numbers.*uses all form of sentences.
(5)Psychosocial development
3 years *separates easily from mothers.
*Flare dark.
4 years *Very independent
*is aggrerrive.
5 years *Tries to follow rules bit may cheat to avoid

losing.
45
*Bossy
6 years *Jealous of siblings.
(6) Sensory development

3 years *color vision fully intact.
(1)Physical development
School-aged 6years to 11 *Weight is approximately 17.5-25-

children 5kg.
6to 8 years
*Height is approximately 110-124cm.
*Pulse is 90+15 beats/min.
*Respiration is 21+3breaths /minute.
*Blood pressure is 100/60+16/10mm hg.
8to 10years *Weight is approximately 22-32 kg.

*Height is approximately 121-5-136.5
cm.
*Pulse is 85+10 beats /min

*Respiration is 20+3/min.
*blood pressure is 12/60 +16/10mm
hg.
10 to 11 *Weight is approximately 25-40 kg.

*Height is approximately 131-5.
years A+10
*147.5 cm at 10 years.
years
46
A+12 years *Pulse is 90=20beats/min Respiration

is 19+3/min
*Blood pressure is 109/58 +16/10mm
hg.
(2)Motor development
6to8years (a) Gross motor
*Rides bycle without training wheels.

*Runs, jumps, a limbs, haps.
8 to 10 years
*Races
*Throw a ball skillfully overhead.
10 to 11 years
*Enjoys all physical activities
*catches tennis ball with one hand.
(b)Fine motor
6 to 8 years *Baths self-unrested
8to 10 years *Learns cursive writing
*cursive writing improved
10to11 years *Dresses self completely
*Dressing and grooming skills develop.
(3) Cognitive development
47
6to 8 years *Attention span increased

*can tell time
8to 10
years. *shows interest in casual relationships.
*Memory spans increasing.

6 to 8 *Receptive language.
years * develops a sense of humor and enjoys telling
jokes.
8 to 10 *Follows suggestions better then commands.

years
10 to 11 *Uses parts of speech correctly.

years
(5) Intellectual development

10 to 11 *Interested in “why “and “how”.
years
(6) Psychosocial Development
6to 8 *develops of sense of industry begins

years *Has a “Know it all “attitude.
8 to 10 *Curious about everything.

years *Have reasonable fears.
*is sincere and confident.
10to 11 *Respect parents and their role.
years
48
(7) Sensory development
(1)Physical development
6 to 8 years *Proper eye vision.
Adolescents 12 to 18 *Weight
Years
*Males-approximately 38-60.
*Females approximately 40-60kg.
12 to 13
*Height
years (early
adolescence) *Male approximately 154-172cm.
*Females Approximately 153 -167 cm.
*Pulse 65+8 beats/minute.
*Respiration 19+3/minute
*Blood pressure.
*Male-114/68+10/14mmhg
*Female-112/66+10/12mm hg.
49
14-16 years *Weight
(Middle Male- approximately 50-60kg.

adolescence)
Females-approximately 42-64 kg.
*Height
Males –Approximately 164-180 cm.
Females-approximately 155-169 cm.
*Pulse rate is 63+8 beats/minute.
*Respirator is 63+3beats/minute.
*Blood pressure is 116/170+12/14mmhg.
16 to 18 *Weight
years
*Male-approximately 56-80kg.
(late *Female-approximately 48-72 kg.
adolescence *Height
Male-approximately 163-182cm.
)
Female-approximately 156-170 cm.
*Pulse is 70+10 beats/minute.
*Respiration is 17+3 breaths/minute.
*Blood pressure is 126/74+26/16 mm hg.
Eruption of third molars(wisdom teeth)
50
(2) Motor development
12 to 13 years *Motor functions comparable to adults
14 to 16 years *Same as adults
16 to 18 years *Shows talent.
(3)Cognitive development
12 to 13 years *Different method for problem -solving.
14 to 16 years
*Expresses concern for education and vocation.
17 to 18 years *Pursues further education or enters job market.

12 to 13 *Uses distinct development meaning of words.
years
(5) Psychosocial development
12 to 13 *Shows mood swings and extremes of behavior.

years
14 to 16 *Sense of identity develops

Years
51
16 to 18
years *Have fewer but close friends.
(6) Sexual development during Adolescences
Girls
8 to 9 *Sex hormones begin to release.
Years *Hips start rounding out.

*Breast nipple start growing.
9to 10
years
*Breast tissue around and under nipple begins to develop.
10 to 11 *Hair appears on labia.
years
*Internal and external genitalia grow.
11 to 12
years
12 to 13 *Underarm hair growth appears.
years *onset of menstruation.
13 to 14 *clear mucus especially during ovulation.

years
*Pregnancy is parable.
14 to 15
years
(6) Sexual development during Adolescences
Boys
9to 10 *sex hormones begin to release.
years
*Testes become larger.
10 to 11
*Scrotal skin becomes dark in color.
52
years *Prostate begins to function.
11 to 12 *Penis begins to lengthen.

years
*Public hair growth.
12 to 13
years
*Testes color deepens.
13 to 14
years *Underarm hair appears
14 to 15 *Moustache begins as fine hair.

years
*Voice change begins.
15 to 16
*sperm matures and can cause pregnancy.
years
*facial and body hair becomes heavier.
16 to 18
years *Acne occurs.
Chapter-9
Child behavior
53
Child behavior
Normal behavior of children depends on the child’ sage, personality and physical
development.
Common behavior disorder

Behavior problem are viewed as discrepancy between the child‘s behavior and
demands placed on him by his parents, teachers and colleagues.
Types of behavior disorder
1.Habit disorder
(a)Thumb sucking
(B) Nail biting
(c)Tics
(d)Enuresis
(e)Stealing
(f)Telling lie
2. Speech disorder
(a)Stammering/stuttering
(3)Eating disorder
(a)Pica
(b)Anorexia nervosa
(c)Bulimia Nervosa
(4) Sleep disorder

(a)Night mares
(5)Personality disorder
54
(a)Temper tantrum
(b) Juvenile delinquency
(c)Shyness
(1) Habit disorder

(a)Thumb sucking –Thumb sucking is defined as non-nutritive sucking of fingers or
thumb.
Age of occurrence
It starts 0-1year but it usually discreet after six months. Most children stop thumb
sucking between three to six years.
Causes-(1) Parental causes

(a) Over protection by parents
(b) Neglect by parents
(c) Strictness of parents
(2) Due to teachers
(a)Excretive strictness
(b)Excessive punitive behavior
(3)Due to siblings
(a)Excessive competition
(b)Separation
(4)Other causes
(a) Loneliness and boredom
(b) Tiredness
(c) Anxiety
Problems
Dental Problem, Misaligned teeth, Malformation of upper plate, Misproncrincing’
Tend “d”.
Management
Do’s
1. Divert the child’s attention
2. The hands and fingers of child should be kept busy in some interesting activity
like drawing.
3. Praise and reward to the child for not sucking thumb.
55
4. Put gloves on chills’ shand or wrap the thumb with bandage.

5. A non-toxic bitter testing substance can be applied on child’s thumb.
6. Encourage the child to socialize.
Donte’s
1. Do not scold the child or punish.
2. Do not remove thumb from mouth force fully.
3. Do not tie child’s thumb and fingers tightly.
4. Do not beat the child.
(b) Nail biting (only chophagia)

Nail biting is a common oral habit in children and adults. It is just a way of coping
with stress or comforting self.
Causes
Boredom, to release stress or anxiety, habitual, Nervousness lack of confidence
felling shy, fear.
Management
1. the most common treatment, which is cheap and wisely available, is application
of a clear bitter tasting, nail polish to the mails.
2. Don’t punish the child.
3. Keep the fingers nails of child neatly trimmed.
4. Don’t pressurize the child to stop biting nails. Reassure the child with love and
affection.
5. Help the child become aware of this bad habit.
6. Holding a smooth stone or marvel in free hand while reading or writing and
then make child practice daily.
Tics disorder
It is characterized by in Volunteer movements of sounds that are purpose lers.tics
can be of following types.
56
Simple
Using only a few muscles or simple word.
Simple motor tics

There are simple meaning leers move mints like eye blinking, shoulders
schlucks.The usually last leers than one second saturating of shoulder tinge
pirtujehan.
Simple phonic tics

There are meaning leers sounds or noises like throat cleaning, coughing or hiring.
Complex
Using many muscles group or renitences.
Complex motor tics

There tics involve slower, longer and purposeful and more purpose full likes
sustained looks or biting or facial gestures.
Complex phonic tics

There tics include words phrases which may be abuse, abnormal and shows
ridiculous behavior.
For example shut up, or yes you have done it.
Age of occurrence
2 to15 years.
Causes
Emotional factors
Abnormal neuron transmitters. Habit
Management
Completion of necessary dig norict test including self-reports by child and parents.
57
Cognitive behavior therapy

Patients are asked to perform tic movement foes specific period of time
interspersed with brief period of the rest.
Medication
Typical Nero lap tics like, Hallo period, Primo zine and tetra benzene.
(d)Enuresis (Bedwetting)
It is a disorder of in –violent urination in children.
Age of occurrence
Two to three or four to five years if it is continues after five fears than it can be a
serious enuresis disorder.
Primary Enuresis
In this condition children have never been trained to control urination.
Secondary enuresis
In this condition children have been successfully trained but still bet wetting
continues in response to stress.
Nocturnal Enuresis
It means bet wetting during nights.
Mixed
It includes both Nocte- diurnal types.
Causes
1. It appropriate toilet training.
2. Lack of developmental functioning in order to stay dry.
3. Genetics
58
4. Emotional Factors
5. Anatomical defect of urinary tracked and bladder.
Management
1. Try to build child’s self-confidence.
2. Do not scold threat and punish the child.
3. Aroura the child after two to three hours of sleeps and asks him to walk to
toilet.
4. Bedwetting alarms set in the loud tone or sensing moisture of bed wetting
alarm. This helps child to wake at reinsertion of full bladder.
Medication
Imipramine and nortriptyline.
(2) Speech disorder

Stammering/stuttering
It is a speech disorder in which a flow of speech is disrupted by involuntary

repetition and pro-elongation of sounds and words. Also there are some silent
pauses or blocks.
Clinical features
1. Problems in starting a word
2. Hesitation before sustain sound.
3. Repetition of sound or word.
4. Speech may come out in blocks.
5. Shivering of lips and jaws.
6. Interference of words like “hum”.
59
Causes
1. Development factor
2. Cleft lip
3. Cleft palate or tongue tie
Neurogenic stuttering
Shock or brain injury may affect the signals between brain and speech co –
Ordination.
Psychological factors
Stress, embarrassment and fear.
Gender
More in males
Management
1. Do not put pressure on child.
2. Give the chilled sufficient time to express him.
3. Never criticize for his /her speech.
Encourage the child to speak clearly by teaching him/her songs or nursery

rhymes.
4. make the child feed that you are interesting in his talks.
(3)Eating disorder
Pica is characterized by an appetite for substances largely non –rutrivtve (such as
clay substances such as chalk /clay mud etc.
Age of occurrence
Not specific but continues more than one month.
60
Types
1. Amjlophoagia
Consumption of starch.
2. Coprophagy
Consumption of animal faces.
3. Geophony
Consumption of soil clay or chalk.
4. Hyolophagia
Consumption of glass.
5. Pago phage
Consumption of hair or wool.
6. Trico phage
Consumption of hair or wool.
7. Urophagia
Consumption of urine.
Causes of Pica
Acquired taste for neurological gala mechanisms like iron defiolncy or chemical
imbalance.
1. Mental disability
2. Family issues
3. Parents neglect
4. Pregnancy
5. Specific appetite caused by mineral defiance.
Management
Combination of psychical, environmental, dietary and family guidance approach.
Other treatment techniques are as fallow

1. Presentation of attention, food or toys not contingent on pica being attempted.
2. Discrimination training between edible and non-edible items.
61
3. Detect nutritional deficiencies and treat them. For e.g. Anemia, Hypocalcemia
etc.
4. Make meal times pleasant.
5. Meet the emotional needs of child.
6. Don’t leave the child alone.
7. Keep the child busy as boredom may give him time for eating non-edible.
(4) Sleep disorder
Sleep problem are common during the preschool year. There problems resolve
and diminish as the child. Gets older.
Age of occurrence
Pre-schooler age.
Clinical feature
Wake up, crying, scared in school age, sleep walking.(suman bullish)and sleep
talking occur in about 15 years children mainly boy.
Management
1. Establish a bed time routine.
2. Establish a wake –up time.
3. Avoid giving stimulants such as sugar or caffeine to the child near betimes.
4. Make the bedroom cozy and inviting.
5. Avoid disturbances in sleep like television.
6. Maintain silence in and near bedroom.
7. Be with the child while he falls asleep.
8. Provide pleasant activity like story telling prior to sleep.
(5)Personality disorder
(a) Temper tantrum is a behavior problem, where children assert their
independent by violently objecting to discipline through the display of anger at
controllable level.
62
Age of occurrence
Toddlers
Clinical feature
1. Anger by lying on the floor.
2. Kicking or stamping their feet.
3. Breath holdings spell.
4. Banging of head.
Causes of temper tantrums

1. Emotional insecurity
2. Lack of sleep and fatigue
3. Imitation of adults
4. Frustration
5. Un met needs
6. Attention seeking.
Management
1. Educate the parents that temper tantrums are child’s way of releasing
frustration so they should ignore them.
2. Find out the cause of frustration.
3. Adequate rest and sleep to the child.
4. Parents should show the child that he is loved even through his behavior is
disapproved.
5. Parents should be good role model for the child.
6. Parents should not be over protective for the child through them should
provide security and support to the child.
(b)Juvenile delinquency
Juvenile delinquency is an anti-social behaviour.in which a child or adobe scent
purposefully and repeatedly does illegal actives.
The Common forms of presentation of juvenile delinquency are

1. Constant disobedience
2. Lying
3. Stealing
63
4. Fire setting
5. Destructiveness
6. Cruelty
7. Truancy from school
8. Running away from home
9. Sexual problems
10. Gambling
11. Drug and alcohol intake with dependence.
Causes
1. Genetics
2. Body build
3. Gender
4. Age
5. Intelligence
6. Family background
Management
(a) Preventive therapy
(b) Corrective therapy
Protective Therapy/Punitive therapy Re formative, rehabilitative therapy
(c) Shyness
Shyness leading to complete with drawls is considered as a behavior problem.
Causes of shyness
1. Genetic inheritance
2. Environmental causes like lack of exposure cultural norms /society etc.
Management
1. Assess the cause of shyness.
2. Talk to the child
64
3. Provide exposure to the child by arranging small get to gather with peer
group.
4. Do not pay attention on the child mistake.
5. Do not compare the child with other children.
6. Do not criticize the child.
7. Reward the child whenever he performs well or takes on initiative.
8. Encourage the child to gain self-confidence.
9. Help the child to develop his potentials and talents.
10.Do not force the child to socialize, as this may aggravate shyness.
Chapter -10
65
Children with special needs
Children with special needs

1. Impairment
Any loss or abnormality of anatomical structure or function.
2. Disability
It refers to functional impairment due to symptoms of disease.
3. Handicap
It refers to the restrictions faced by a person with handicap a disability in fulfilling
normal roles depending on age, sex social and culture factors. Handicap is the loss
or limitation of opportunities to take part in community life on an equal level with
others.
Type of handicaps
Physical handicaps mental handicaps social handicaps
(1) (2) (3)
Blind Mental Retardation Orphans

Deaf Cerebral palsy abused children
Dumb Step parents and children of
Crippled divorced
Delinquents
Causes of handicaps
1. Genetic factors
2. Lack of oxygen supply to the fetal brain in pregnancy.
3. Difficult instrumentals mental delivery.
66
4. Nutritional deficiencies like vitamin A deficiency and vitamin D.

5. Forceps delivery.
Diagnosis/Assortment of Handicaps
1. Absence of normal reflexes
2. Feeding problems
3. Lack of movements
4. Abnormal posture of new born.
Blinders
Definition according to who the inability to count fingers in day light from a
distance of 3 meters is defined as blinders.
Prevalence and etiology

1. Vitamin A deficiency
2. Malnutrition
3. Eye in functions
4. Injuries
5. Tumors
Problems of a blind child
1. Problems of attachment
2. Inability to use hands as argon of
3. Problem in language development.
4. Problem in language development.
5. Dependence/Behavioral Problems.
Management
1. The Blind child should be trained to recognize tactile and auditory stimulation,
which will be helpful in locomotion.
2. Help the child in speech development by providing speech therapy.
3. These children should be trained to .Recognize and use common house hold
things.
4. They should be trained to travel indepandery using various tools and
techniques like long care guide dogs, GPS internet system etc.
67
Deafness
Definition Deafness refers to hearing loss, which is perfect from birth or early
childhood and that, renders an individual incapable of maintaining meaning
fulauditary contact with the environment. Hearing loss may be mild, moderate,
severe or profound .total hearing loss is rare.
Cause of deafness
(a) (b) (c)
Before birth At Birth after birth

Drug intake by mother Prolonged Labor Due to trauma
Infections
Drug toxicity
Disease in mother’s anoxia
Problems of deaf children

 Emotional immaturity
 Absence of creativity and inner control.
 Inability to understand, interpersonal relationship
Management
The child must be trained in audiology and speech therapy and sign language are
very helpful for them.
Mental Handicaps
Mental Cerebral
Retardation Palsy
68
Mental retardation
Definition
Mental retardation is a disorder characterized by significantly sub average general
intellectual functioning associated with significant impairment in adaptive
behavior including thinking, learning, social and occupational adjustments.
Clarification
1. Mild M.R
2. Moderate M.R
3. Severe M.R.
4. Prefound M.R
Management
1. Demonstrate and teach simple activities of daily living to the child like brushing
teeth combing etc.
2. Teach the child patiently and in a simple manner.
3. Demonstrate each activity daily till the child learns it.
4. Provide positive reforming to motivate the child.
5. Demonstrate buttoning and unbuttoning of clothes.
6. Provide the child with clothes having big holes and buttons.
7. Teach the child how to eat.
8. Teach the child to chew the food slowly and properly.
9. Provide special utensils like big spoon with long handle and special cup so that
the child can grasp them properly.
Cerebral palsy
Definition it is a chronic no-Programed motor dysfunction cured by damage to
the motor areas of brain. (Bolster and, burns, 2004.) The word ‘Cerebral ‘refer to
cerebrum which is the affected area of brain and palsy refers to disorder of
movement.
Causes
 Genetic or problems chromosomal anomalies.
 Central nervous system infection.
 Head trauma
69
 Meningitis
 Pre-eclampsia
Management
1. Physical therapy
2. Occupational therapy
3. Speech therapy
4. Drugs to control seizures, relaxer muscle spasm. (e.g. Benzodiazepines.)
5. Surgery to correct anatomical abnormalities or release tight muscles.
6. Communication aids such as computers with attached voice synthesis.
Social handicaps
Definition socially “handicapped children “are three who are unable to confirm to
to an acceptable social standard, while may or may not be intellectually normal or
physically handicapped. They refuse to confirm to the customs of the society.
Children categorized as socially handicapped are
Orphans neglected Delinquent Children of divorced or

Children Children Step parents
(a) (b) (c) (d)
(a)Orphans
A child who has lost both parents is called an arphan.An orphan does not have
any surviving parent to care for him or her.
Behavioral problem associated with orphans

Bet wetting, personality problem, deprerrion, disturbances in eating.
70
(b)Neglected children
These are infants who are neglected or are cared for rarely.
Definition
It is defined as the adverse consequence of inadequate or negligent parenting. It
may be unintentional or inaduertent.about 1-3% of children in developed
countries are abused or neglected.
In list type of neglect
Physical Nutritional Emotional Medical care

Neglect
Neglect neglect Deprivation
Education
Neglect
(c)Children of divorced or step parents

Behavioral reaction of the child to parents’ divorce depends upon the
child’s age.
Reaction of a young child to parents divorce is as fallow.

 Resistance to toilet training
 Sleep disturbances
 Temper tantrums
 Learning problems in school
 Feeding problems/refused to feeds.
71
Chapter 11
Child health, common diseases and Remedial measures

Child health
Child health is a state of physical, mental, intellectual, social and emotional well-
being. Healthy children live in families, environments, and communities that
provide them with the opportunity to reach their fullest developmental potential.
Common diseases and remedial measures

Acute respiratory infections, diarrhea a and fever are very common in children
below the age of five years. All children suffer from there liners several times each
year. Nanny or care taker of child need to have the following drugs /supplies for
compating common health problems in children.
Oral drugs
Amoxicillin tablets, Chloroquine tablets, ciprofloxacin tablets oral rehydration salt
(ORS) pediatric cotrimoxazole tablets Paracetamol Vitamin-A
Caught and difficult breathing

After checking the child for general danger signs, check of the child has cough or
difficult breathing if yes , proceed further to count the child’s breathing rate and
check for the presence of chest in drawing.
Count the breathing Rate

If the child’s age is The child has fast breathing if shishas
2 months up to 12 months 5’breaths or more per minute.
2months up to 5years 40 breaths or more per minute.
72
Look for chest in drawing

Look for chest in drawing at the lower chest wall. Chest in drawing is present
when lower chest wall goes in as child breaths in.Normally the the lower chest
wall comes out when the child breaths in.
Treatment
1) Continue exclusives breast feeding for up to 6 months.
2) Give extra fluids to older children.
3) If possible, give cough soothing remedies like warm tea,
4) Amoxicillin tablets should be crushed and mixed with food or fluid before
giving to young children who cannot swallow.
5) If it becomes sever, take urgently to hospital.
Diarrhea
Diarrhea is frequent passage of watery stool.
Check all children with diarrhea for 4signs of dehydration

General Condition
General condition is the child is lethargic or unconscious rustlers and irritable.
Sunken eyes
Decide if you think the eyes are sunken. Check whatever child’s eyes look unusual.
Check the child’s ability to drink

 Offer the child plain clean water to drink. if the child does not take any
water at all all or vomits it out completely or is not able to keep any water
down, the child is not able to drink.
 If the child reaches out for the cup or glare or if child opens the mouth
when water is offered or begins to cry when the water is take away the
child is drinking eagerly.
73
 The child drinks normally if water is take after some encouragement by the
care taker.
Check for skin pinch

 Pinch the skin on the abdomen (between the halva and side of the
abdomen)
 With thumb and the first finger by lifting it for one second and releasing
it.after leaving the skin, see how soon the skin returns to normal.
 If the skin comes back very slowly that is it takes more than 2 seconds the
skin pinch is very slow. If the skin does not return to normal immediately,
the skin pinch is slow.
 If the skin punch returns to normal immediately, it is normal.
Diarrhea treatment Instructions

 If the child
has the  If the child has two or  No
following more of the following dehydration.
signs she has signs. She has some
severe DEHYDRATIDN.
DEHYDRATID  Rustlers, Irritable
H.  Sunken eyes
 Lethargic or  Drinks eagerly, thirsty
unconscious.  Skin pinch goes back
 Sunken eyes slowly.
 Not able to
drink or
drinking
poorly
 Skin pinch
goes back
very slowly.
74
 Refer urgently to a  Treat some dehydration Provide home care

hospital for treatment of with Or provide home care
severe dehydration.
 If the child is a blue to
drink, give frequent sips
of ORS on the way.
Fever
Fever is very common problem in young Children. Check if the child has fever. See
if child feels hot to touch.
Treatment
High fever-Temperature more Fever present 9Temper aturemore
than 38-5 degree c. than 34.5degree c but not high.
Give paracetamol Give extra fluid.

Continue feeding
Dose of Paracetamol
Give paracetamol every 6 hours until high fever is gone.
Age (Weight) 100mg tablet 500mg tablet
75
2 Months- 1 1/4
3years (4-14kg.
3-5 years (14- 1/2

19kg) 11/2
Management of young infant C<2months Age.

All young infants should be checked for
(i)Signs of serious illness and

(ii)Feeding problems
The signs of serious illness requiring referral include the

following
Convulsions
Check if young infant has Convulsions.
Nasal flaring
Nasal flaring is widening of the nostrils when the young infant breathes in.
Grunting
Grunting is the soft, short sounds a young infant makes when breathing out.
Grunting occurs when an infant is having trouble breathing.
Bulging fontanelle
The fontanelle is the soft spot on the top of the young infant’s head, where the
bones of the head have not formed completely. Hold the young infant in an
upright position. The infant must not be crying. Then look at and feel the
fontanelle.
Umbilical renders extending to the skin

If the renders extends to the skin of the abdominal wall it is a serious infection.
76
Sever skin pustules

Large skin pustules and pustules with areas of surrounding renders indicate a
serious infection.
Drowsy or unconscious
A drowsy young infant is not awake and alert when she should be. An
unconscious infant cannot be wakened at all.
No ‘Spontaneous movement
If the infant who is awake has no spontaneous movement when observed for one
minute, this indicates series illness.
 Yellow palms and soles

 No attachment to the breast or no sucking at all.
Baby Check for feeding problem

 Poor positioning or
 Not well attached to breast or
 Not sucking effectively or
 Less than 8 breastfeeds in 24 hours or
 Receives other foods or drinks or
 Low weight for age.
Home care for young infant

 Breast feed frequently, as after and for as long as the infant wants, day or
night, during sickness and health. Do not give water, other liquids or foods.
 In cool weather, cover the infant’s head and feet and dress the infant with
extra clothing. Make sure the young infant stays warm at all times.
 Advise mother to wash hands with soap and water after defecation and
after cleaning the bottom of the baby.
 Do not apply anything on the cord and umbilicus dry.
77
Chapter-12
Immunity and immunization schedule immunity
Immunity and immunization schedule immunity

The resistance offered by the host to the harmful effects of pathogenic microbial
infection is called immunity. Immunity is of following type. A condition of being
able to resist a particles disease by counteracting the effects of its products is
called immunity.
Immunity
Innate Acquired
Non Specific Specific Active Passive
Natural artificial Natural Artificial
78
1) Innate immunity
This is the basic immunity which is genetically passed on from one
generation to the other. It is present in the individual by birth.
2) Acquired immunity
The immunity acquired during life time of an individual is known as acquired
immunity it is of two types.
(a)Active immunity
Stimulating active immunology glial defense mechanism through administration
of antigens usually before natural exposure to infections agents is known as active
immunity. The immunity which results from the antibodies by the immune system
of an antigen in known as active.
(b)Passive immunity
Temporarily supplying performed exogenous antibodies to suppress disease, give
soon after or before exposure to infecting agent is known as par rive immunity.
Par rive imam can occur naturally, When material antibodies are Trans furred to
the fetus through the placenta.
Immunization Schedule
Universal immunization schedule in India
79
Primary Table 79 Route of

Vaccination Vaccine Administration
Age BCG Intradermal
At Birth OPV-Zero dose Oral
6 weeks OPV-1st dose Oral

DPT-2nd dose Intramuscular
10 weeks OPV -2nd dose Oral

Dpt-2nd dose Intramuscular
14 weeks OPV-3rd dose Oral

DPT-3rd dose Intramuscular
9-12 moth Measles Vaccine Subcutaneous
Booster doses
16-24months OPV Oral
DPT Intramuscular
5 years
10 years DT
Intramuscular
TT
Intramuscular
16 years TT
Intramuscular
Pregnant Women
Gestational period
As early as possible Intramuscular

during pregnancy (first st
TT-1 dose
contact)
80
I moth after Intramuscular

1st dose
TT-2nd dose
If previously Intramuscular
vaccinated within TT booster
3years
BCG, Bacillus calmette-guerin, OPV, Oral Polio vaccine,DPT diphtheria, Pertussis,

tetaraus, Dt, diphtheria and tetanus toxoids,TT,tetanus toxoid.
Chapter -13
Preventing accidents and injuries
Preventing accidents and injuries

The safety of at risk from accidents and injuries, as well as crime. Providing a safe
environment, putting prevention measures into practice, and teaching children
methods of self-protection are all ways to reduce the potential for harm to
children.
Common childhood accidents

1. Fall
2. Burn
81
3. Fracture and dislocation

4. Sprain
5. Cut and abrasions
6. Animal bites
7. Poisoning
8. Drawing
9. Foreign bodies
10.Suffocation
11.Crush injuries
Types of accidents
(a)Occurring Outside home
(b)Occurring in the home
According to severity
(a)Major
(b) Minor
Factors affecting accidents

Age
2-10 years of age accidents more.
Sex
Boys between 10-years of age are more prone accidents.
Personality
Bright and alert children are more prone to accidents because they are eager to
do new activities.
Ordinal position
Elder and younger children are more protected but middle ones are neglected.
Time of day
Most accidents occur in afternoon.
82
Weather condition
Accidents occur more in rainy reason.
Place
Accidents may occur in home or on road side.
Causes of accidents
1. Curiosity among children.
2. Lack of supervision, especially at home.
3. Lack of play grounds and over crowded streets.
4. Impulses of the moment
5. Lack of past experience
6. Inability to judge danger
Effects of children
1) Physical damage
Even a minor accident can cause cut, fracture, scar, sprain dislocation etc.
2) Psychological damage
The child thinks that people will feel that he is naughty and carolers if has too
many bandages on body. He thinks himself a wounded hero”
Common childhood accidents

1) Motor vehicle
Both as passengers and as pedestrian’s children may get injured.
2) Burns
Children may get burnt from heating appliances like stoves, irons, get injured.
(a)Open fire
Fire places, Outdoor fires, matches, lighters.
(b)Hot liquids
Tea, coffee, Bath water.
(c)Electronic-Circuit
Defective wiring, unguarded outlets
83
(d)Strong acids and alkalis

Ammonia
3) Drawing
In bath tub, sink, wells, ponds, rivers etc.
4) Falls
From furniture, stairs, terrace etc.
5) Poisoning
Drugs (likes relatives, antitype tension) cleaning agents.
6) Suffocation
Plastic bags, discorded refrigerator
7) Foreign bodies
Nuts especially peanuts, coins bolts, beads etc.
8) Cut and punctures
Knife, scissors, tools etc.
9) Crush injuries
From wringers
Prevention of house hold and outdoor accidents in toddlers

Hazards Protection
1) Drugs, Chemical, Sharp Keep in closets cabinets on drawers which
are locked
Instruments
2) Burns and scalds keep guards around stoves, fire.
Places
Keep stoves and utensils back from idge.
Use no hanging table cloths or runners.
3) Fall from unguarded use gates

Stairs, windows
4) Furniture makes discipline Consistent and use
84
Gates
5) Car doors Use safety looks.
6) Electricity Use plastic plugs
Repair defective wiring
Place fans, Mixers power
Equipment out of reach.
7) Drawing and bathroom never leave full tub unguarded

Use consistent discipline at beach
8) Traffic Look the door of the car.

9) Aspiration of foreign bodies Keep small objects like marbles, jocks
buttons.
10) Ingestion of led Repair defective walls and repaints
Peeling surfaces with lead-free paints.
Prevention of accidents
1) During infancy the parents or care takers are inters responsible for child’s
safety. But as he develops and gains independence in actions and wide range
of unsupervised activity.
2) Physicians and nurses can expert their best influence by discussing potential
hazards and methods of averting them with parents of developing children.
3) Many of the most serious accidents are preventable so the national safety
council, children’s bureau, state and local depth departments, insurance
companies.
4) Safety programmers launched.
5) Children should be taught to exert their own control.
6) Restraint and discipline are necerrary.
7) With potentially dangerous toys orocluptions for the ones which are
forbidden.
8) With potentially dangerous activates, disciplined must be firm prompt.
85
Weather Emergencies
Cold weather
When temperatures drop, children need extra attention to stay warm, safe and
healthy young children are less likely to recognize when they are cold and more
likely to lose body heat quickly due to their smaller size. Here are some tips to
protect children when the thermometer dips.
1) Think layers
Put several layers of clothing on your child and make sure their head, neck and
hands are covered.
2) Beware clothing hazards

Scarves and hood strings can strangle smaller children so use other clothing to
keep them warm.
3) Chick in on warmth
Tell children to come inside if they get wet or if they are cold. Then keep watching
them and checking in.
4) Use sunscreen
Children and adults can still get sunburn in the winter sun c.
5) Install alarms
More house hold fires happen during the winter so make sure you have smoke
and carbon monoxide alarms in your home.
6) Trach technique
It takes time to master fun winter activities like speeding so make sure children
know how to do the activity safely.
7) Prevent nosebleeds
If your child suffers from minor winter nosebleeds use a cold air humidifier in
their room.
86
8) Watch for danger signs

Signs of frostbite are pale, gray or blistered skin on the fingers, ears, nose and
toes. Signs of hypothermia are shivering, slurred speech and unusual clumsiness.
If you think your child has hypothermia call 9-1-1 immediately.
Hot weather
Keep your baby cool and protect them from the sun-children can’t cool
themselves as well as adults so they are more at risk of overheating and
developing a heat-related illners.The tips below will help keep your child happy
and healthy in the heat.
 Babies less than six months old should be keeping out of direct sunlight. Their
skin contains too little melanin, the pigment that provides some protection
from the sun.
 Apply a high factor sunscreen to your baby’s skin. Many brands produce
sunscreen specifically for babies and young chidden with a sun protection
factor (SPF) as high as 30t.Apply sunscreen regularly.
 Cover your baby’s body, arms and legs with clothing, and make sure you put a
sunhat with a wide brim or a long flap at the back to protect their head and
neck from the sun.
Keeping cool
 Follow the tips below to help keep your baby cool and safe during hot weather.
 Playing in a padding pool is a good way of keeping babies cool. Keep the pool in
the shade during very hot weather.
 A cool bath before bedtime is often beneficial.
 Keep your baby’s bedroom cool during the day by closing blinds or curtains.
 If you have an air-Conditioner, Make sure the room does not get cold, setting the
temperature to about 24 to 26 Celsius is low enough.
87
Prickly heat
Prickly heat is an itchy rash of small, raided red spots that causes a stinging or
prickling sensation on the skin. Babies and children are also more at risk of getting
Prickly heat because their sweat glands are not fully developed. Creams such as
Zinc and castor oil creams will protect the skin from heat.
Avoid dehydration
Like adults, Babies need to drink plenty of fluids to avoid becoming dehydrated.
You know your baby is hydrated if there are six to eight pale wet nappies a day.
For the first six months when your baby is only on breast milk or formula, you
shouldn’t be giving them any water.
Once they are on solids, you can give your baby small amounts of cooled boiled
water throughout the day.
Heat stroke
Heat stroke Occurs when the body can no longer cool itself and starts to
overheat. When the core temperature rises above 40 degrees the cells inside the
body begin to break down and important parts of the body stop working.
Symptoms of heatstroke include

 Rising body temperature
 Heavy sweating that suddenly
 Increased thirst (but later, as the baby gets weaker, They may drink less)
 Pale, Clammy skin
 Rapid breathing
 Dry mouth and eyes
 Headache, muscle cramps
 Being sleepy
 Confusion, shortness of breath and vomiting.
What to do
If your baby or older child has any of signs above, they need urgent treatment call
ambulance and take your baby to a hospital or health center.
88
While you are waiting for ambulance to arrive, move them to a cool area as
quickly as possible, remove excess clothing and try to cool them by fanning them.
If they are conscious, give them cool, not cold, water to drink. The best drinks are
those that are those that are recommended for gastro.do not add salt to any of
the drinks.
Child care during the monsoon/Rainy season

Monsoons not only bring fun with them, but they even bring along some seasonal
infections. In order to take care of your child during the rainy reason, you have to
make your house and kids monsoon proof’ or at least monsoon ready.
Build immunity
Monsoon is the season for cold, flu and other air borne and water borne
infections. It’s better to build mood immunity by giving foods which are rich in
vitamin c and other foods which help to boost their immune system.
Set the room temperature
It’s usually cold and breezy when it rains. A sudden change in temperature will
affect your child’s health. Keep the house dry all the time and set his room
temperature to a moderate.
Say No to outside food

We know that water borne infections like diarrhea and food poisoning are
common during monsoons. We do not know the kind of water they use, to make
food outside. It’s better to give him homemade food. Include hot soups and hot
milk in his daily diet.
Avoid getting drenched

It’s easy to control infants from not going out in the rain. There days because of
the high pollution, we cannot expect rain water to be safe. Do not let them play in
the rain. Pack a rain coat and water proof shoes in his school bag.
89
Prepare your own monsoon Aid kit

Prepare a kit with medicines which help with cold-cough. Cough syrups, Vitamin c
supplements, Syrups for cold or fever balms etc. Can be added to your kit.
Other important tips

 Keep your house clean.
 Make your house insect proof.
 Use antiseptic liquids while washing clothes and cleaning house.
 Teach them to use sanitizer FOR HAND WASH.
 Give them a hot bath if they get drenched in the rain.
 Keep their feet dry all the time.
Chapter -14
Other safety consideration
90
Other safety consideration

Telephone safety tips
It is hard to supervise children while you’re talking on the telephone. That’s why
you should keep all conversations as short as possible and avoid personal calls
that are not absolutely necessary.
Something to keep in mind about telephone use when you are

baby sitting
 Ask the parents if and how they would like their phone answered.
 Be polite and brief when answering the phone.
 Remember that you may tie up the phone line when you use the internet.
 Keep all conversation as short as possible and avoid personal calls that
aren’t absolutely necerrary.
 Call the parents, an adult you trust or the police if you get a cell that scares
you.
 Never leave the children alone while answering the phone.
 Do not tell the caller that you are the baby sitter as that the parents are a
way.
 Do not call, text message or instant message your friends or have them call
you for a long conversation while on the job.
Personal safety
Your own safety and health are just as important as the health and safety of the
children you baby sit.
 Get to know the parents and families of the children you babysit and meet
their pets.
 Tell you parents where you will be when to expect you home and how to
contact you.
 If babysitting for a certain family makes you feel uncomfortable, don’t
babysit for them.
 Do not wear jewelry that dangles or has sharp edges.it can scratch or hurt
you or the children.
 Keep your fingers nails short.
 Do not babysit when you are sick.
91
 Do not use alcohol, tobacco or other things.
Danger from strangers
92

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GB NANNY CARE INSTITUTE PHAGWARA

Tips to be great nanny

Good behavior of Nanny

3. Use time effectively and appropriately.

A nanny is care taker of a child who takes place of mother.

Nany creates an activity for children

Nanny as a housekeeper cleaned the house.

Nanny takes care of a child or

Nanny helped the child in dance.

A nanny played with the child.

Nanny helped the child in the park.

Nanny cooked the food for the child

Nanny drives the car for outing the child.

Loves the company of children

Basic understanding of child development

Advocate for the children

Prepared to handle an emergency

Connection with children

Learning Management skills

The communication facilities flow of information ideas beliefs perception advice,

Learning management skills

Preparing people to accept change

Developing good human relation

Starting of any activity begins with communication which brings information

Coordination the effects of various people at work in the organization.

3. Aids in decision making

It facilitates access to the vital information required to take decision.

5. Palming becomes easy

6. Provides effective leadership

Attitude Element Seeing Attitude

sKnowledge Treatment Touching Knowledge

Social system Structure Tasting Social System

Sender Message Message Message Receiver

(In code) Channel (de code)

Other type of communication

Physical e.g. Deaf ,dumb, blind

Perceptual e.g. Negative, thoughts

Emotional e.g. Crying, laughing

Cultural e.g. Religion, Cast

Language e.g. Foreign, language

Gender e.g. Male ,female

Lack of feedback e.g. Non response(reply)

Methods to overcome Barrier

Non-Verbal communication- communication without words Non-Verbal

Methods of Non-Verbal communication

Positive body language

Negative body language

 Allows time to speaker to think.

Tips for improving non-verbal communication

Good communication skill

Management in Nanny care Business of Nanny

Ask your parents

Assessing self-skills as a nanny

2. My leaderships and nanny skill include

1. Very good 2.Good 3.Needs work

1. Very good 2.good 3.needs work

Staying calm in an emergency

1. Very good 2.good 3.needs work

Communicating well with children

1. Very good 2.good 3.needs work

Role modeling positive behavior

Recognizing and respecting difference

Correcting misbehavior appropriately