Growth and Development of Children - Context specificity: differences related to

cultural values, beliefs, and experiences

Theoretical Approaches to Growth and Development of
Children
▪ GROWTH is an increase in the number and size
of cells. Measured in terms of QUANTITY.
▪ DEVELOPMENT is capacity of functioning or skill.
Measured in terms of QUALITY.
Assessment of GROWTH:
1. Physiologic loss of weight a couple of weeks after
birth: 5-10% of birthweight.
2. Most rapid during infancy (Doubles at 6 mos.
Triples at 1 year) and adolescent stages.

Growth, Maturation, Development Assessment of DEVELOPMENT:

▪ Growth: a physiologic increase in size through 1. DDST- Denver Developmental Screen Test
cell multiplication or differentiation. 2. MMDST- Metro Manila Developmental Screen
▪ Maturation: changes that are due to genetic Test
inheritance rather than life experiences, illness,
or injury. Areas Assessed:
▪ Development: physiological, psychosocial, and ▪ Gross Motor Skills – skills done by the large
cognitive changes occurring over one’s life span muscles (Legs & thighs) (CEPHALOCAUDAL)
due to growth, maturation, and learning; ▪ Fine Motor Skills – skills done by small muscles
assumes orderly and specific situations lead to (hands) (PROXIMODISTAL)
new activities and behavior patterns. ▪ Interpersonal-social
▪ Language
Principles of Growth and Development
▪ Development is orderly and sequential Stages of Human Development
▪ Development is directional ▪ Infant: birth–1 year
▪ Development is unique ▪ Toddler: 1–3 years
▪ Development is interrelated ▪ Preschooler: 3–6 years
▪ Development becomes increasingly ▪ School-age child: 6–12 years
differentiated ▪ Adolescent: 12–19 years or later
▪ Development becomes increasingly integrated
and complex Assumptions about Human Nature
▪ Children are competent ▪ Original sin
▪ New skills predominate ▪ Innate purity
▪ Tabula rasa
Principles of Growth and Development ▪ Behavioral consistency
1. Unique – individualized.
2. Unified – all areas are important: physical, social Theories of Human Development— Psychoanalytic
(play). Perspective
3. Continuous process – begins at conception and Freud: psychosexual
ends at death. ▪ Id
4. Rate of growth varies: ▪ Ego
- rapid stages (growth spurts): Infancy & ▪ Superego
Adolescent ▪ Stages: oral, anal, phallic, latency, genital
- slow periods (growth gaps): Toddler,
Preschooler, Schooler DEVELOPMENTAL THEORIES
5. Directional: Sigmund Freud considered sexual instincts to be
- Growth – horizontal and vertical significant in the development of personality. At each
- Development: stage, regions of the body assume prominent psychologic
– cephalo-caudal (gross motor) significance as sources of pleasure.
– proximo-distal (fine motor) ▪ ORAL (BIRTH – 1 YEAR)
- Baby’s chief source of pleasure is the MOUTH.
Issues of Human Development (cont.) - Infants sucks for the enjoyment as well as
▪ Passive versus active nourishment.
▪ Critical versus sensitive period - Gains gratification by swallowing, chewing,
- Critical: limited time span biting and eating.
- Sensitive: a time span optimal for - Unable to delay gratification.
development - Begins to develop self-concept from the
▪ Universality versus context specificity responses of others.
- Universality: similar developmental
pathways ▪ ANAL (1-3 YEARS)
- Zone of gratification is ANUS/BUTTOCKS.
 - Child derives sensual satisfaction from
withholding and expelling feces.
- Bladder and bowel training occur and is a
major task.
- Sexuality begins to develop. (Sex differences,
learned words pertaining to anatomy and
elimination.
- Conflict of “Holding On” and “Letting Go”
gradually resolves as bowel training
progresses. Resolution occurs once bowel
control is firmly established.
TOILET TRAINING
- Readiness is 18-24 months.
- Bowel training accomplished before bladder.
- Complete night bladder training at 4 or 5-years-
old.
SIGNS OF TODDLER’S READINESS FOR TOILET TRAINING
▪ Stays dry for 2 hours with regular bowel
movements.
- Can sit, walk and squat.
- Can verbalize the desire to void or defecate.
- Exhibits a willingness to please parents.
- Wants to have soiled diapers changed
immediately.
NOTE: Toilet training should not be initiated during times
of stress, such a new baby, a move, a divorce, or a
vacation.
▪ PHALLIC (3-6 YEARS)
- The child’s pleasure centers on the
GENITALIA and masturbation.
- Time of “Family Romance”
▪ Oedipal Complex
▪ Electra Complex
- CASTRATION ANXIETY
- Values and rules learned from parents.
- Guilt and self-esteem develop.
- Desires are repressed and introjection and
role identification with parent of the same
sex.
▪ LATENCY (6-12 YEARS)
- Time of relative sexual indifference/sex
instincts relatively quiet.
- Time of relative calm between more
turbulent stages.
- Development of self-esteem closely linked
with developing sense of worth and value.
- Mastery of learning (Uses creative energies
to influence environment)
- Relationships with same sex peers develops.
▪ GENITAL (12 YEARS & BEYOND)
- Adolescent focus on the genitals as an
erogenous zone and engage in masturbation
and sexual relations with others.
- Period of sexual maturity directed toward
heterosexual relationships.
- Sexual activity increases and sexual identity
is strengthened or attacked.
- Periods of renewed sexual drive with conflict
between adolescent’s need for sexual
satisfaction and society’s expectations for
control of sexual expression.
- Core concerns are body image development
and acceptance of the opposite sex.
Theories of Human Development — Psychoanalytic
perspective
Erikson: Psychosocial
▪ Trust versus mistrust
▪ Autonomy versus shame and doubt
▪ Initiative versus guilt
▪ Industry versus inferiority
▪ Identity versus role confusion
PSYCHOSOCIAL THEORY
TRUST vs MISTRUST (BIRTH – 1 YEAR)
▪ Foundation of all future psychosocial tasks.
▪ Baby develops sense whether world can be
trusted.
▪ SIGNIFICANT PERSON: Mother/Caregiver
▪ TRUST
o Infants who receive attentive care learn
that life is predictable and that their
needs are promptly meet.
▪ MISTRUST
o Infants whose needs are consistently
unmet or who experience significant
delays develop a sense of uncertainty.
▪ PSYCHOSOCIAL VIRTUE: HOPE
▪ FEARS: Stranger anxiety; loud noises, falls,
sudden movement in the environment.
▪ PLAY: SOLITARY: reflect development and
awareness of the environment.
▪ AGE-APPROPRIATE TOYS
o safe, no sharp edges, not small, non-
detachable parts
o Birth – 3 months: mobiles, mirrors,
music boxes, rattles, stuffed animals
without detachable parts
o 4-6 Months: squeeze toys, busy boxes
and play gyms
o 7-9 Months: cloth-textured toys,
splashing toys, large blocks and large
balls
o 10-12 Months: durable books, with large
pictures, large building blocks, nesting
cups, and push-pull toys
AUTONOMY vs SHAME AND DOUBT (1-3 YEARS)
▪ Psychosocial theme: “HOLD ON OR LET GO”
▪ Struggle of giving self-chance to gain
independence from the mother and breaking the
symbolic ties/dependence from the mother.
 ▪ An internal struggle for self-identity: LOVE vs
HATE
▪ Ritualism, negativism and independence
predominate social interaction.
▪ Temper tantrums, seeks security
blankets/objects
▪ Starts to delay gratification
▪ PSYCHOSOCIAL VIRTUE: WILL
▪ FEARS: Separation anxiety, loud noises, going to
sleep, large animals
▪ SIGNIFICANT PERSON: Family
▪ PLAY: Parallel, enhance locomotion skills (push-
pull toys)
▪ AGE APPRPRIATE TOYS
o Safe, non-detachable, no small parts
o Dolls and housekeeping toys
o Play phones and cloth books
o Appropriate rocking horses and “riding”
trucks, finger paints, play clay, large-
piece wooden or plastic puzzles, and
large blocks
INITIATIVE vs GUILT (3-6 YEARS)
▪ Child learns the ability to try new things and
learns how to handle failure.
▪ Period of intensive activity, play and consuming
fantasies.
▪ Child interjects parent’s social consciousness
▪ Child develops initiative when trying out new
things and is not overwhelmed by failure.
▪ PSYCHOSOCIAL VIRTUE: PURPOSE
▪ FEARS: Dark, being left alone esp. at bedtime,
large animals (large dogs), ghosts, body
mutilation, pain and objects and people
associated with painful experiences
▪ SIGNIFICANT PERSON: Family, grandparents,
siblings and preschool experiences
PLAY: Associative, enhance gross and fine motor
development
▪ AGE APPROPRIATE TOYS
o Tricycle, big wheels, gym sets, wading
pools and sandboxes
o Large blocks, puzzles, crayons, paints
and simple crafts.
o Dress-up clothes and dolls,
housekeeping toys, play tents, puppets,
doctor and nurse kits to imitative play
and imagination.
INDUSTRY vs INFERIORITY (6-12 YEARS)
▪ Child learns how to make things with others and
strives to achieve success.
▪ Child must learn skills of the culture or face
feelings of inferiority.
▪ PSYCHOSOCIAL STRENGTH: SKILL
▪ FEARS: Failure at school, bullies, intimidating
teachers
▪ SIGNIFICANT PERSON: Teacher
▪ PLAY: Cooperative, competitive and complex.
Complex puzzles, collections, quiet board games,
reading.
▪ AGE APPROPRAITE TOYS
o Increasing complex board and card
games
o Book and crafts
o Music and art
o Athletic activities (swimming), team
activities, video games.
IDENTITY vs IDENTITY CONFUSION (12-18 YEARS)
▪ ADOLESCENCE
o Adolescent determines own sense of
self.
o Development of who, what, and where
they are going become focus (SELF-
CONCEPT)
o Period of rebellion and uncertainty.
▪ PSYCHOSOCIAL VIRTUE: FIDELITY
▪ SIGNIFICANT PERSON: Peers
▪ PLAY: Sports, camping, fishing gear, video and
video games, computer games, radios and
compact disk players, personal telephone.
INTIMACY vs ISOLATION (20-45 YEARS)
▪ (YOUNG ADULTHOOD)
▪ Person make commitments to another.
▪ Isolation and self-absorption occur if
unsuccessful.
▪ Independent from parents, possible
marriage/partnership.
▪ Major goals to accomplish in career and family.
▪ “Sandwich Generation” (35-45 years)
▪ PSYCHOSOCIAL VIRTUE: LOVE
▪ SIGNIFICANT PERSON: Spouse/Partner
GENERATIVITY vs STAGNATION (45-65 YEARS)
▪ MIDDLE ADULTHOOD
▪ Mature adult is concerned with establishing and
guiding the next generation or else feels personal
impoverishment or incompleteness.
▪ Relates to older and younger generations
▪ Become “Pillars of Community”
▪ Prepares for retirement
▪ PHYSICAL CHANGES: graying hair, wrinkling skin,
pains and muscle aches, menopause
▪ PSYCHOSOCIAL VIRTUE: CARE
INTEGRITY vs DESPAIR (65- OLD AGE)
▪ OLD ADULTHOOD
▪ Achieves sense of acceptance of own life, adapts
to triumphs and disappointments with a certain
ego integrity.
▪ Accepts inevitability of death or else falls into
despair.
▪ Appraisal of life and changing social roles
▪ Self-concern and withdrawn
▪ PHYSICAL CHANGES: increasing physical decline,
increasing forgetfulness, changes in lifestyle with
 modification on physical limitations, appearance
of chronic diseases
▪ PSYCHOLOGICAL VIRTUE: WISDOM
COGNITIVE DEVELOPMENT
Swiss psychologist Jean Piaget proposed four major
stages of cognitive Development. Cognitive development
is the growth in thought processes that enables one to
acquire and use knowledge about the world. Piaget
believed that the core of intelligent behavior is an inborn
tendency for people to adapt to their environment.
PIAGET’S SENSORIMOTOR STAGE OF COGNITIVE
DEVELOPMENT
SENSORIMOTOR STAGE (BIRTH-2 YEARS)
▪ Infant changes from a being who responds
primarily through reflexes to one who can
organize activities in relation to the environment.
▪ Uses sensory and motor abilities to comprehend
world.
a. SUBSTAGE 1 (BIRTH- 1 MONTH)
▪ REFLEXIVE STAGE
- This period is marked by the use of
innate and predictable survival reflexes.
- No coordination from their senses, do
not grasp an object they are looking at.
▪ NO OBJECT PERMANENCE
- The realization that an object or person
continues to exist even when out of
sight.
b. SUBSTAGE 2 (1-4 MONTHS)
▪ PRIMARY CIRCULAR REACTIONS
- Marked by stereotyped repetition and
the infant’s focus on his own body
as the center of interest. (e.g.
infant discovers own body parts)
▪ FOCUS: Infant’s body
o Hand-mouth and ear-eye coordination
develop.
o Development of primary circular
reaction to acquired adaptation then
finally organization.
o Enjoyable activity for this period: a rattle
or a tape of parent’s voice.
o NO object permanence.
c. SUBSTAGE 3 (4-8 MONTHS)
▪ SECONDARY CIRCULAR REACTIONS
- Infants learns to initiate, recognize &
repeat pleasurable experiences from
environment.
- Coincides with new interest to
manipulate objects in the environment.
- Memory traces are present; infant’s
anticipates familiar events.
- Actions intentional but not initially goal-
directed.
▪ Begin to show PARTIAL OBJECT PERMANENCE.
o Good toy for this period: mirror
o Good game: peek-a-boo
d. SUBSTAGE 4 (8-12 MONTHS)
▪ COORDINATION OF SECONDARY SCHEMES
- Behavior is more deliberate and
purposeful as infant’s coordinate
previously learned schemes (e.g. looking
and grasping a rattle) and use previously
learned behaviors to attain their goals
(e.g. crawling across the room to get
desired toy).
- Can anticipate events.
▪ Begin to develop object permanence (first hiding
place even being moved).
▪ Recognize shapes and sizes of familiar objects.
o Good toy: nesting toys (colored boxes)
e. SUBSTAGE 5 (12-18 MONTHS)
▪ TERTIARY CIRCULAR REACTIONS
- Infants show curiosity as they purposely
vary their actions to see results.
- Try new activities and use trial and error
in solving problems.
- Child is able to experiment to discover
new properties of objects and events.
▪ Object permanence developed further. (Follow
series of displacements and look in last place
rather than first.)
o Good game: throw and retrieve
f. SUBSTAGE 6 (18-24 MONTHS)
▪ MENTAL COMBINATIONS
- Toddler have developed a primitive
symbol system (language) to represent
events. (Symbolic thought)
- Basic understanding of cause and effect.
No longer confined to trial and error.
- Develops of insight.
▪ Object permanence fully developed.
o Good toys: blocks, colored plastic rings.
PREOPERATIONAL (2 – 7 YEARS)
▪ Child develops a representational system and
uses symbols such as words to represent people,
places and events.
▪ Comprehend simple abstractions but thinking is
basically concrete and literal.
▪ SYMBOLIC FUNCTION
- is the ability to learn by using symbols.
▪ SYMBOL
- is a mental representation to which
consciously or unconsciously, a person
has attached meaning.
1. PRECONCEPTUAL PHASE (2-4 years)
▪ Child forms concepts; less complete &
logical than adult concepts.
- Centration, conservation of matter
(height & weight)
 - reversibility & animism (confuse reality
and fantasy)
▪ The child makes simple classifications. (to
form design or figure)
▪ The child associates on event with a
simultaneous one. (TRANSDUCTIVE
REASONING)
▪ The child exhibits egocentric thinking.
▪ Good toys: items that require imagination
such as modeling clay.
2. INTUITIVE PHASE (4-7 YEARS)
▪ The child becomes capable of classifying,
quantifying, and relating objects but
remains unaware of the principles behind
these operations.
▪ The child exhibits intuitive thought
process.
▪ The child is egocentric.
▪ The child uses many words appropriately
but lacks real knowledge of their meaning.
CONCRETE OPERATIONS STAGE (7-12 YEARS)
▪ Marked by inductive reasoning, logical
operations and reversible concrete thought.
▪ Uses memory to learn broad concept and
subgroup of concepts. (Fruit and apple)
▪ Classifies according to attributes such as color
and seriation.
▪ Understands reversibility, conservation of
matter.
▪ Transition from egocentric to objective thinking.
▪ Typical activities: collecting and sorting objects,
ordering items according to size, shape, weight
and other criteria.
FORMAL OPERATIONS (12 YEARS – ADULTHOOD)
▪ Develops abstract reasoning which include
inductive and deductive reasoning, the ability to
connect separate events and the ability to
understand later consequences.
▪ Adolescent thinks beyond the present and
delights in “that which is not.”
▪ Development of:
o Idealism (perfect word)
o Egocentrism (“Everyone is watching me
and concerned about me.”) (Personal
fable)
MORAL DEVELOPMENT
Lawrence Kohlberg was developmental psychologist and
then moved to the field of moral education. Kohlberg
believed and was able to demonstrate to studies that
people progressed in their moral reasoning through a
series of stages.
I. PRECONVENTIONAL MORALITY (4-10 YEARS)
▪ Emphasis in this level is on external
control. These standards are those of
others, and they are observed either to
avoid punishment or to reap rewards.
▪ STAGE 1. OBEDIENCE AND
PUNISHMENT
- “Whatever is rewarded is good;
whatever is punished is bad.”
- Individual obeys rules to avoid
punishment.
- They ignore the motives of an
act but on the consequences of
the act.
▪ STAGE 2. INSTRUMENTAL EGOISM AND
SIMPLE EXCHANGE
- “You scratch my back, and I’ll
scratch yours.”
- “I’ll do something good for you
if you do something good for
me.”
- Children conform to rules out of
own self-interest and
consideration for what others
can do for them in return.
II. CONVENTIONAL MORALITY (10 – 13 YEARS)
▪ The individual perceives the
maintenance of the expectations of his
family, group, or nation as valuable in its
own right, regardless of immediate and
obvious consequences.
▪ Children want to please other people.
▪ They want to be considered “good” by
those opinions that matter to them.
▪ STAGE 3. INTERPERSONAL
CONCORDANCE
- “Am I a good boy or a good
girl?”
- Good behavior is what pleases
others and approved by them.
- Behavior is judged by intention.
- One earns approval by being
nice.
▪ STAGE 4. LAW AND ORDER
- “What if everybody did it?”
- Oriented to abiding by law and
responding to the obligations of
duty.
- Operates on social system and
conscience.
- Good is defined by laws of
society, by doing one’s duty. A
law should be obeyed even if
it’s unfair.
III. POST-CONVENTIONAL MORALITY (13 YEARS,
OR UNTIL YOUNG ADULTHOOD, OR NEVER)
▪ This level marks the attainment of true
morality.
▪ The person acknowledges the possibility
of two conflict between two socially
 accepted standards and tries to decide
between them.
▪ The control of conduct is now internal
both in the standards observed and
reasoning in right and wrong.
▪ Stages 5 and 6 may be alternative levels
of the highest level of moral reasoning.
▪ STAGE 5. SOCIETAL
CONSENSUS/SOCIETAL CONTRACT
- People think in rational terms,
valuing the will of the majority
and the welfare of society.
- While they recognize that there
are times when human need
and law conflict, they believe
that society in the long run
should obey the law.
▪ STAGE 6. PRINCIPLED CONSCIENCE
- People do what they think is
right regardless of legal
restrictions or the opinions of
others.
- They act in accordance with
internalized standards, knowing
that they would condemn
themselves if they did not.
Growth and Development of the Infant
Physiological Development
1 month – 1 year
▪ Weight and height
▪ Head growth
▪ Motor development – strongly related to
physical, cognitive and social development which
provides the infant to explore a new
environment.
General Principles
▪ Voluntary behaviors follow the disappearance of
primitive reflexes. To be able to willingly grasp an
object the infant must first lose the voluntary
grasp.
▪ Pronation occurs before the supination. The
infant must be able to pick up objects (pronation
before being able to put objects in the mouth
(supination).
▪ The ability to grasp an object precedes the ability
to relieve it. (Dixon & Stein 2000)
▪ Gross motor: ability to use large muscle groups
to maintain balance, for postural control, and for
locomotion.
▪ Fine motor: ability to coordinate hand-to-eye
movement in an orderly and progressive manner.
GROWTH AND DEVELOPMENT (0 – 12/18 Months)
▪ Birth weight doubles at 6 months.
▪ Birth weight triples at 12 months.
▪ Baby sits steadily, unsupported at 8 months.
▪ Baby walks with assistance, may attempt to
stand, at 12 months.
▪ Teething begins at 3 – 6 months.
GROWTH AND DEVELOPMENT (1 MONTH)
FONTANELLE
Anterior fontanelle = 2 inches (4 – 5cm) width; closes
at/between 12 – 18 months.
Posterior fontanelle = 0.5 inches (0.5 – 1cm) width; closes
by 2 months.
GROWTH AND DEVELOPMENT (12/18 MOS to 3 Years)
▪ Birth weight quadruples by 3 years old.
▪ Full set of baby teeth comes in by 30 months.
▪ Blood pressure 99/64 mmhg.
▪ Pulse 110 beats/min.
GROWTH AND DEVELOPMENT (2-3 MONTHS)
SENSORY
▪ Follows a light to the periphery. Has binocular
coordination (vertical and horizontal vision).
▪ Listen to sounds.
SOCIALIZATION
▪ Smiles in response to a person or object; cries
less Laughs aloud and shows pleasure in making
sounds.
GROWTH AND DEVELOPMENT (4-5 MONTHS)
PHYSICAL
▪ Birth weight doubles.
▪ Drools
MOTOR
▪ Can hold the head up and use the forearm for
support.
▪ Can sit when back is supported; balances the
head well.
▪ Can sustain a portion of weight when held in
standing position.
▪ Reaches for and grasps an object with whole
hand but misjudges distance.
▪ Can carry a hand or object to the mouth at will.
▪ Grasp, Tonic Neck and Moro have disappeared.
SENSORY
▪ Recognizes familiar objects and people.
▪ Accommodation is developing.
GROWTH AND DEVELOPMENT (6-7 MONTHS)
WEIGHT: 90 to 150 g (3-5 oz) weekly during second 6
month.
HEIGHT: 1.25 cm (1/2 inch) a month.
HEAD CIRCUMFERENCE: 0.5 cm (1/5 inch) a month.
Teething may.. two lower central incisors, followed by
upper incisors.
MOTOR
▪ Can turn equally well from stomach or back.
▪ Sits fairly well unsupported, esp. if placed in a
forward-leaning position.
▪ Lifts head off table when supine.
 ▪ Can approach a toy & grasp it w/ one hand; can ▪ Enjoys surroundings and will explore away from
transfer a toy from one hand to the other and mother.
from hand to mouth. ▪ Fearful in strange situations or strangers; clings
▪ Plays with feet and puts them in mouth. to mother.
SENSORY ▪ May develop "security" blanket.
▪ Has taste preferences; will spit out disliked food.
▪ Begins to recognize things are still present even Psychosexual Development
though not seen. Cognitive development: Piaget's sensorimotor stage has
SOCIALIZATION AND VOCALIZATION four substages
▪ "Stranger Anxiety". ▪ Reflexes
▪ Makes polysyllabic vowel sounds. ▪ Primary circular reactions
▪ Vocalizes "m-m-m-m" when crying; cries easily ▪ Secondary circular reaction m
on slightest provocation but laughs just as ▪ Coordination of secondary schema
quickly.
Health Promotion
GROWTH AND DEVELOPMENT (8-9 MONTHS) Health screening
MOTOR ▪ PKU
▪ Sits steadily alone; pulls self to standing position; ▪ Iron deficiency anemia
stands holding onto furniture. ▪ Lead poisoning
▪ Has a good hand-to-mouth coordination. ▪ Hypothyroidism
▪ Developing pincer grasp, w/ preference for use of ▪ Immunizations
one hand over the other. ▪ Vision screening
▪ Crawls, may go backward at first. ▪ Hearing screening
SENSORY ▪ Dental care
▪ Depth perception is increasing. Nutrition
▪ Displays interest in small objects. ▪ Breast milk or formula
SOCIALIZATION AND VOCALIZATION ▪ Solid foods
▪ Define social attachments is evident; shows ▪ Weaning
anxiety with strangers. ▪ Use of pacifier
▪ Responds to own name; is separating from Communication
mother by desire to act on own. ▪ Receptive language
▪ Reacts to adult anger and cries when scolded. ▪ Expressive language
Has imitative and repetitive speech using vowels Colic
and consonants such as "Dada and Mama". ▪ Recurrent episodes of unexplained crying and
▪ inability to be consoled
GROWTH AND DEVELOPMENT (10-12 MONTHS) Sleep
▪ WEIGHT: Birth weight triples. ▪ Sleep consolidation
▪ HEIGHT: Birth length increases by 50% ▪ Diurnal cycle
▪ Head and chest circumference are equal. ▪ SIDS
▪ Upper and lower and lateral incisors usually have Stranger and separation anxiety
erupted for a total of 6-8 teeth. Alternative child care
▪ Hematocrit: 29-41%. ▪ Center-based care
MOTOR ▪ Family child care
▪ Creeps (abdomen off the floor). ▪ In-home care
▪ Stands alone for short times; walks with help; Play
moves around by holding onto furniture. Safety promotion and injury prevention: family teaching
▪ Can sit down from a standing position without ▪ Safety checklist
help. ▪ Hidden dangers
▪ Can eat a spoon and cup but needs help; prefers
using fingers. FEEDING MILESTONES DURING INFANCY
▪ Can play pat-a-cake and peek-a-boo; holds a ▪ At birth, the full-term infant has sucking, rooting
crayon to mark paper. and swallowing reflexes.
▪ Helps in dressing (e.g. putting an arm through ▪ Newborn feels hunger and indicates desire for
sleeve) food by crying; expresses satiety by falling
SENSORY asleep.
▪ Visual acuity 20/50. ▪ At 1 month, has strong extrusion reflex.
▪ Discriminates simple geometric forms. ▪ By 5-6 months, can use fingers to eat teething
SOCIALIZATION AND VOCALIZATION crackers or toast.
▪ Shows emotions such as jealousy, affection and ▪ By 6-7 months, developmentally ready to chew
anger. solid foods.
 ▪ By 8-9 months, can hold a spoon and play with it
during feeding.
▪ By 9 months, can hold own bottle. ANAL (1-3 YEARS)
▪ By 12 months, can drink from a cup with some ▪ Zone of gratification is ANUS/BUTTOCKS.
spilling at times still preferred. ▪ Child derives sensual satisfaction from
withholding and expelling feces.
ACCIDENT PREVENTION DURING INFANCY ▪ Bladder and bowel training occurs and is a major
NEWBORN INFANT task.
▪ Don't smoke around infants. ▪ Sexuality begins to develop. (Sex differences,
▪ Don't leave an infant unattended in a high place learned words pertaining to anatomy and
or unstrapped in a safety seat. elimination.
▪ Use a rear-facing car safety seat. ▪ Conflict of "Holding On" and "Letting Go"
▪ Make sure furniture is free of lead-based paint. gradually resolves as bowel training progresses.
▪ Crib slats should be no further than 2 3/8 inches; Resolution occurs once bowel control is firmly
the mattress and bumper pads should be tight established.
fitting.
2 MONTHS Freud's Anal/ Erikson's Autonomy vs Shame and Doubt
▪ Don't hold an infant while smoking or drinking ▪ Finds pleasure in controlling his eliminatory
hot liquid. function
▪ Set water heater at 120°F-130°F; Test bath water ▪ Toilet Training begins
with inner aspect of the wrist before immersing Description of Period
the infant. ▪ Feeling of INDEPENDENCE
4 MONTHS ▪ Behaviors to Observe
▪ Keep small objects and small pieces of food out ▪ Negativism "NO!" stage – set limits
of the infant's reach. Don't use teething biscuits- ▪ Temper tantrums – ignore the behavior
they may become small and obstruct the airway.
6 MONTHS Psychosocial Development
▪ Child-proof the home, especially the kitchen and ▪ Gaining self-control
bathroom. Remove all dangerous items or place ▪ Developing autonomy
out of reach. ▪ Increasing independence
▪ Use syrup of ipecac in home for emergency use. ▪ Psychosocial milestones
▪ Keep poison control number on phone; use as
needed. Cognitive Development
▪ Milestones
Growth and Development of the Toddler ▪ Communication with toddlers
Physiological Development ▪ Piaget
▪ Neurological System o Sensorimotor phase
▪ Musculoskeletal System o Preconceptual phase
▪ Gastrointestinal/Genitourinary System ▪ Moral Development
o Decreased Appetite: Physiologic
Anorexia PIAGET'S SENSORIMOTOR STAGE OF COGNITIVE
▪ Cardiorespiratory System DEVELOPMENT
▪ Sensory System SENSORIMOTOR STAGE (BIRTH-2 YEARS)
▪ Infant changes from a being who responds
Assessment of Development primarily through reflexes to one who can
▪ DDST- Denver Developmental Screen Test organize activities in relation to the environment.
▪ MMDST- Metro Manila Developmental Screen ▪ Uses sensory and motor abilities to comprehend
Test Areas Assessed: the world.
▪ Gross Motor Skills – skills done by the large
muscles (CEPHALOCAUDAL) Kohlberg and Moral Development
▪ Fine Motor Skills – skills done by small muscles Postconventional level
(hands) (PROXIMODISTAL) ▪ Social contract/legalistic orientation stage
▪ Interpersonal-social ▪ Universal ethical principles orientation stage
▪ Language
GROWTH AND DEVELOPMENT (15 MONTHS)
Psychosexual Development MOTOR
▪ Freud: anal stage ▪ Walks well alone by 14 months with a wide-
▪ Domestic mimicry: imitation of domestic roles based gait; creeps upstairs.
and activity ▪ Builds tower of two blocks; enjoys throwing
▪ Family teaching objects and picking them up.
 ▪ Drinks from a cup and can use a spoon.
VOCALIZATION AND SOCIALIZATION
▪ Can use four to six words, including name.
▪ Has learned "no" which may be said while doing
a requested demand.
MAJOR LEARNING EVENTS
▪ Sphincter control adequate when child can walk.
▪ Able to retain urine for 2 hours.
▪ Daytime bowel and bladder control: 2 years
▪ Night control: 3-4 years of age

GROWTH AND DEVELOPMENT (18 MONTHS)

PHYSICAL
▪ Growth has decreased and appetite lessened –
"PHYSIOLOGIC ANOREXIA” Health Promotion
▪ Anterior fontanel is usually closed. ▪ Negativism: "No!"
▪ Abdomen protrudes, larger than chest ▪ Ritualism and regression
circumference o Ritualism: need to maintain sameness.
MOTOR o Regression: return to earlier, safer, more
▪ Runs clumsily; climbs stairs or up on furniture. familiar behavior.
▪ Imitates strokes in drawing. ▪ Discipline
▪ Drinks well from cup; manages a spoon well. o Limit setting
▪ Builds tower of three to four cubes. o Appropriate discipline
VOCALIZATION o Corporal punishment
▪ Says 10 or more words. ▪ Sibling rivalry
▪ Has a new awareness of strangers. ▪ Temper tantrums
▪ Begins to have temper tantrums. ▪ Toilet training
▪ Very ritualistic, has a favorite toy or blanket, ▪ Child care
thumb sucking may be at peak. ▪ Play
▪ Nutrition
GROWTH AND DEVELOPMENT (2 YEARS) ▪ Sleep
PHYSICAL ▪ Dental health
▪ WEIGHT: About 11-12 kg (26-28 lbs)
▪ HEIGHT: About 80-82 cm (32-33 inches) Safety Promotion and Injury Prevention
▪ TEETH: 16 temporary; begin visits to dentist ▪ Developmentally-specific prevention
MOTOR ▪ Auto safety
▪ Gross motor skills quite refined. ▪ Home and environmental safety
▪ Can walk up and down stairs, both feet on one ▪ Water safety
step at a time, holding onto rail. ▪ Toy injuries/gun safety
SENSORY
▪ Accommodation well developed. Routine Health Screening
▪ Visual acuity 20/40. ▪ Health monitoring
VOCALIZATION AND SOCIALIZATION ▪ Immunizations
▪ Vocabulary of about 300 words; uses short, two
to three-word phrases, also pronouns.
▪ Obeys commands; shows signs of increasing
autonomy and individuality; makes simple
choices when possible.
▪ Still ritualistic, especially at bedtime.
▪ Can help undress self and pull on simple clothes.
▪ Does not share possessions, everything is "mine."

GROWTH AND DEVELOPMENT (30 MONTHS)

PHYSICAL
▪ Full set of 20 temporary teeth.
▪ Decreased need for naps.
MOTOR
▪ Walks on tiptoe; stands on one foot
momentarily. Builds a tower of eight blocks.
VOCALIZATION AND SOCIALIZATION
▪ Beginning to see self as a separate individual
from reflected appraisal of significant others.
▪ Still sees other children as objects.
▪ Increasingly independent, ritualistic, and
negativistic.