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GROWTH AND
DEVELOPMENT OF
TODDLER
INTRODUCTION
• The word is derived from “to toddle”, which means to
walk unsteadily, like a child of this age.
• The toddler period extends from age 1 year to
approximately 3 years of age.
• The toddler who learned to trust the parents during
infancy now can use this trust in exploration and
investigation of a world beyond the parent’s arms.
• The toddler years are a time of great cognitive,
emotional and social development.
DEFINITION
• A toddler is a young child who has only just
learned to walk or who still walks unsteadily
with small, quick steps. The toddler period
extends from age 1 year to 3 year of age.
PHYSICAL GROWTH AND
DEVELOPMENT
BIOLOGICAL GROWTH
WEIGHT
- Toddler gains 1.8 to 2.7 kg a year.
- At 2 years- 12 kg.
- At 2.5 years- weight is 4 times that at birth.
- Gains about 5 kg between 1 & 3 years.
HEIGHT
- Height increases by 10 to 12.5 cm per year.
- In 2nd year- about 85 cm.
HEAD CIRCUMFERENCE
- Head circumference by 2.5 cm during second year (49-50 cm).
- By 2 years, the chest circumference exceeds that of head.
FONTANELLE CHANGES
• Anterior fontanelle closes between 12 to 18 months.
DENTITION
• At 2 years, the toddler has about 16 teeth, and
• At 2.5 years the full set of 20 temporary teeth has erupted.
PHYSIOLOGICAL DEVELOPMENT
• The physiological functioning of the body is mature
by the end of the toddler period, with the exception of
the endocrine and reproductive systems.
INTEGUMENTARY SYSTEM
• Fine body hair begins to grow on the arms and legs. The hair
on the head becomes coarser and darkens as it gradually
approaches the eventual mature color.
CARDIOVASCULAR SYSTEM
• The pulse rate decreases and the blood pressure increases
during the toddler period. The heart and blood vessels increase
in size as the child grows.
RESPIRATORY SYSTEM
• The structures of the respiratory tract increase in size, with an
accompanying increase in thoracic volume, leading to
decreased respiratory rate.
GASTROINTESTINAL SYSTEM
• The salivary glands have reached functional maturity by the end of the second year.
The toddler can chew food and keep it in the mouth so that the salivary enzymes
can begin to act upon it.
• The capacity of the stomach also increases, and the rapidity with which food passes
through the gastrointestinal tract decreases, so that the toddler can be satisfied with
less frequent feedings than were necessary during infancy.
• With continued growth, hydrochloric acid secretion in stomach increases, providing
protection against various types of organisms. The incidence of infectious diarrhea,
so common during infancy, is decreased.
GENITOURINARY SYSTEM
• With continuing maturation of the kidneys, by 2 years of age
the toddler is physiologically able to conserve water and to
concentrate urine on a level similar to that of the adult.
NERVOUS SYSTEM
• The number of brain cells is complete by the beginning of the toddler period.
• They continue to grow until the brain has reached two thirds of its adult size at 2
years of age.
• Rapid development of the brain leads to increasing control of behavior but initially
results in some disorganization in young toddlers, manifested by a very short
attention span.
• Myelination of the spinal cord is achieved gradually as toddlers show increasing
ability to exert control over posture and coordinated movements.
MOTOR DEVELOPMENT
• Motor development depends upon maturation of muscular,
skeletal and nervous system.
• It is usually termed as gross and fine motor development.
GROSS DEVELOPMENT
• Gross motor development involves control of the child over
his her body by increasing mobility.
• The important gross motor developmental milestones include
head holding, sitting, standing, walking, running, climbing
upstairs.
• It promotes independent locomotion and proceeds fine motor
activities.
15 Months
 Assumes standing position without help.
 Loses balance when walking around corners or stopping suddenly.
 Creeps up stairs.
 Throws small objects repeatedly and picks them again but may fall.
18 Months (1.5 years)
 Walks sideways and backwards.
 Walks upstairs with one hand held.
 Runs stiffly, often falls.
 Moves quickly from one place to another. Jumping attempted using both feet.
 Seats self in small chair.
 Climbs on furniture.
 Pulls and pushes toys.
 Pushes light furniture around room.
24 Months (2 years)
 More grown up, steady gait.
 Can walk with heel-toe gait.
 Runs more quickly in more controlled way; has fewer falls.
 Walks up and down stairs.
 Jumps crudely with both feet in place.
 Kicks large ball without falling.
 Picks up object from floor without losing balance.
36 Months
 Stands on one foot alone momentarily.
 Walks on tiptoe for few steps upon request.
 Walks up and down stairs.
 Jumps from step or low chair.
 Rides a walker or pedal car.
 Can throw a large ball overhand 4-5 feet.
FINE MOTOR:-
• Fine motor development depends upon neural tract maturation. Fine motor
development promotes adaptive activities with fine sensorimotor adjustments and
include eye coordination , hand eye co ordination
15 Months
 Builds a tower of 2-3 cubes.
 Makes line with crayon.
 Open boxes.
 Begins to turn pages.
18 Months (1.5 Years)
 Builds tower of 3-4 cubes.
 Imitates a vertical stroke with crayon.
 Turns pages in a book- 2 or 3 at a time.
 Transfers objects hand to hand at will.
24 Months (2 Years)
 Builds a tower of 6-7 cubes.
 Imitates a circular stroke.
 Imitates a horizontal stroke.
 Turns pages of book one at a time.
36 Months
 Builds a tower of 8 cubes.
 Makes vertical and horizontal strokes but may or may not join them to make a
cross.
 Imitates circular stroke- forms closed figure.
 Holds crayon with fingers instead of entire hand.
SENSORY DEVELOPMENT
• Sensory development depends upon myelinization of nervous system and responds
to specific stimuli. Taste, smell, touch, and learning are initial senses present in
newborn born babies. The visual system is the last to mature at about 6 to7 years.
The other senses – hearing, taste, smell, and touch – continue to develop during
toddler period.
15 Months
 Sound localization by head movement in all planes.
 Binocular vision fully developed.
 Look at the pictures intently for prolonged periods of time.
 Can identify geometric forms.
18 Months (1.5 Years)
 Can see better, thus has intense interest in pictures.
 Identifies various shapes.
24 Months (2Years)
 Visual acuity: 20/40.
 Accommodation well developed.
36 Months
 Visual acuity: 20/30.
 Recalls visual images.
LANGUAGE, SPEECH DEVELOPMENT
• 15 Months
 Recognizes names of various parts of body.
 Responds to familiar, simple commands.
 Says 2-6 words.
 Names familiar pictures or objects, such as ‘ball’.
 Shakes head to communicate ‘no’.
18 Months (1.5 Years)
 Identify one or more parts of body when named.
 Identifies pictures of familiar objects when named.
 Uses phrases composed of adjectives and nouns.
24 Months (2 Years)
 Understand more complex sentences.
 Enjoys stories with pictures.
 Identifies four body parts when named.
 Verbalize need for drink, food, or toileting.
36 Months
 Identifies five body parts when named.
 Gives full (first and last) name if asked.
 Talks constantly.
 Uses 4-5 word sentences.
DEVELOPMENT THEORIES
 Psychosocial development.
 Psychosexual development.
 Intellectual development.
 Moral development.
PLAY AND STIMULATION
• DEFINITION:-
• Play is the work of children. It consists of those activities performed for self
amusement by which behavioral, social, and psychomotor changes takes place in
the child.
FUNCTIONS OF PLAY:-
Play during the toddler period stimulates all areas of growth and development . Some of the
more common functions of play to facilitate are:
1. Physical development.
2. Psychosocial development.
3. Cognitive development.
4. Moral development.
5. Language and Speech development.
PLAY RESPONSES DURING THE TODDLER PERIOD:-
• Play in the early toddler period is free and spontaneous. Play during the toddler period
can be of various types : motor, creative, quiet, dramatic.
• Motor play involves large muscles to push and pull toys and light furniture . Small
muscles are used in block play, manipulation of materials, and self care skills.
• Creative play is the manipulation of mud , sand, or clay as well as the use of crayons
and finger paints.
• Quiet activities are being read to, singing simple songs, and the arms in time to music.
NEEDS OF TODDLERS
• The basic needs of toddlers are for love and security, discipline leading to self control,
progression to independence, and achievement of control of bodily functions.
1. Love and security :- Parental love should be constant, unconditional, and openly
expressed, even when the child is misbehaving. This type of love enables the toddler to
grow and to reach out for more mature goals.
Both boys and girls give their first love to their primary care giver usually the
mother. As their needs become more varied – less for physical care and more for
socialization – their attachment to the father increases. When the father gives the same care
as the mother, the infant generally feels attached to and secure with both parents.
Contd.
• During the toddler or early preschool period, the child may select an object that
seems to provide security in the move from the small world of very early childhood.
This security or transitional object, such as a blanket, diaper, toy, or an article of a
parent’s clothing, gives the toddler a sense of control over the environment. The
child may become distressed if the object is taken away to be cleaned or changed in
any way.
Contd.
2. Discipline leading to self control :- Discipline means establishing and adhering to
standards of behavior for the toddler with the goal of self control.
• Discipline is an essential way of preparing the child for adjustment to the world
outside the home.
• If it is to be constructive, discipline must help the child direct unacceptable,
unrealistic, and often futile ways of attempting to reach a goal into effective,
socially approved channels.
• The way parents approach the problem of discipline is perhaps the best indication of
their feelings toward their child.
Contd.
• Achieving control of bodily functions :- Achieving control of the bodily functions
of defecation and urination is one of the major tasks of the toddler period.
• The relative importance of this achievement depends on the culture and the
socioeconomic status of the child’s family.
• In some groups, toddlers do not wear diapers or pants and are permitted to move
through the home and environment excreting at will. In these families, toilet
training is not emphasized so the children in effect must train themselves.
GROWTH, DEVELOPMENT, AND ACCIDENTAL INJURY
• Increased mobility and ease of locomotion :- The development of gross motor
skills enables the toddler not only to move farther more quickly by walking,
running, climbing, and riding a tricycle but also to pull objects around and to
explore areas like pools and ponds without the immediate supervision of an adult.
Although the toddler can move around more easily, many of the skills of mobility
are not refined, resulting in clumsiness and possible injury.
Contd.
• Improved fine motor control :- Because the smaller muscles of the body are
increasingly under voluntary control, the toddler is able to manipulate objects;
throw balls and other objects more forcefully; open containers, doors (refrigerator,
cabinet and closet), gates, drawers, and some windows; explore holes and openings
with fingers; and pull small parts from toys such as sewn-on button eyes from
stuffed animals.
Contd.
• Heightened curiosity about the environment :- Toddlers are curious about
everything in the environment, and they enjoy exploring whether they are
supervised or not. Toddlers explore by putting objects into their mouth and possibly
swallowing them. The toddler’s persistent exploration can very quickly lead to
injury or death as a result of any of these accidents.
Contd.
• Increased sensitivity to the emotional climate of the home :- Any sudden change
in a child’s environment, such as a new baby sitter, moving from one house or
apartment to another, or going on vacation, can upset the routine of the home and
predispose the child to accidental injury. The child’s hunger and fatigue at a time
when the parents are busy, such as the hour before meals, late in the afternoon, or
just before bedtime, can also result in accidental injury.
ACCIDENT PREVENTION
• Accidents are the largest single cause of mortality and disability between the ages of 1
and 4 years, claiming more victims than the six leading fatal distress combined.
1. Motor vehicle accidents.
2. Drowning.
3. Burns
4. Suffocation
5. Falls
6. Poisoning
7. Other types of injuries.
HEALTH SUPERVISION
• Health supervision visits are important during the toddler period to assess the
toddler’s physical status and growth and development, to provide necessary
immunizations, and to assist parents in resolving any concerns they may have.
Visits are usually scheduled about every 4-6 months until 2 years of age and
thereafter about once a year.
Contd.
• Immunizations :- During the second year, the toddler receives immunization
against measles, mumps, and rubella; vaccination against H.influenzae type b is
also recommended.
• Dental Health :- To prevent the dental diseases, children not only must eat an
adequate, low-cariogenic diet but also be protected by good daily oral hygiene,
regular dental supervision, and the use of fluorides and pit-and-fissure sealants.
Growth and Development of a Toddler

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Growth and Development of a Toddler

  • 2. INTRODUCTION • The word is derived from “to toddle”, which means to walk unsteadily, like a child of this age. • The toddler period extends from age 1 year to approximately 3 years of age. • The toddler who learned to trust the parents during infancy now can use this trust in exploration and investigation of a world beyond the parent’s arms. • The toddler years are a time of great cognitive, emotional and social development.
  • 3. DEFINITION • A toddler is a young child who has only just learned to walk or who still walks unsteadily with small, quick steps. The toddler period extends from age 1 year to 3 year of age.
  • 5. WEIGHT - Toddler gains 1.8 to 2.7 kg a year. - At 2 years- 12 kg. - At 2.5 years- weight is 4 times that at birth. - Gains about 5 kg between 1 & 3 years.
  • 6. HEIGHT - Height increases by 10 to 12.5 cm per year. - In 2nd year- about 85 cm.
  • 7. HEAD CIRCUMFERENCE - Head circumference by 2.5 cm during second year (49-50 cm). - By 2 years, the chest circumference exceeds that of head.
  • 8. FONTANELLE CHANGES • Anterior fontanelle closes between 12 to 18 months.
  • 9. DENTITION • At 2 years, the toddler has about 16 teeth, and • At 2.5 years the full set of 20 temporary teeth has erupted.
  • 10. PHYSIOLOGICAL DEVELOPMENT • The physiological functioning of the body is mature by the end of the toddler period, with the exception of the endocrine and reproductive systems.
  • 11. INTEGUMENTARY SYSTEM • Fine body hair begins to grow on the arms and legs. The hair on the head becomes coarser and darkens as it gradually approaches the eventual mature color.
  • 12. CARDIOVASCULAR SYSTEM • The pulse rate decreases and the blood pressure increases during the toddler period. The heart and blood vessels increase in size as the child grows.
  • 13. RESPIRATORY SYSTEM • The structures of the respiratory tract increase in size, with an accompanying increase in thoracic volume, leading to decreased respiratory rate.
  • 14. GASTROINTESTINAL SYSTEM • The salivary glands have reached functional maturity by the end of the second year. The toddler can chew food and keep it in the mouth so that the salivary enzymes can begin to act upon it. • The capacity of the stomach also increases, and the rapidity with which food passes through the gastrointestinal tract decreases, so that the toddler can be satisfied with less frequent feedings than were necessary during infancy. • With continued growth, hydrochloric acid secretion in stomach increases, providing protection against various types of organisms. The incidence of infectious diarrhea, so common during infancy, is decreased.
  • 15. GENITOURINARY SYSTEM • With continuing maturation of the kidneys, by 2 years of age the toddler is physiologically able to conserve water and to concentrate urine on a level similar to that of the adult.
  • 16. NERVOUS SYSTEM • The number of brain cells is complete by the beginning of the toddler period. • They continue to grow until the brain has reached two thirds of its adult size at 2 years of age. • Rapid development of the brain leads to increasing control of behavior but initially results in some disorganization in young toddlers, manifested by a very short attention span. • Myelination of the spinal cord is achieved gradually as toddlers show increasing ability to exert control over posture and coordinated movements.
  • 17. MOTOR DEVELOPMENT • Motor development depends upon maturation of muscular, skeletal and nervous system. • It is usually termed as gross and fine motor development.
  • 18. GROSS DEVELOPMENT • Gross motor development involves control of the child over his her body by increasing mobility. • The important gross motor developmental milestones include head holding, sitting, standing, walking, running, climbing upstairs. • It promotes independent locomotion and proceeds fine motor activities.
  • 19. 15 Months  Assumes standing position without help.  Loses balance when walking around corners or stopping suddenly.  Creeps up stairs.  Throws small objects repeatedly and picks them again but may fall.
  • 20. 18 Months (1.5 years)  Walks sideways and backwards.  Walks upstairs with one hand held.  Runs stiffly, often falls.  Moves quickly from one place to another. Jumping attempted using both feet.  Seats self in small chair.  Climbs on furniture.  Pulls and pushes toys.  Pushes light furniture around room.
  • 21. 24 Months (2 years)  More grown up, steady gait.  Can walk with heel-toe gait.  Runs more quickly in more controlled way; has fewer falls.  Walks up and down stairs.  Jumps crudely with both feet in place.  Kicks large ball without falling.  Picks up object from floor without losing balance.
  • 22. 36 Months  Stands on one foot alone momentarily.  Walks on tiptoe for few steps upon request.  Walks up and down stairs.  Jumps from step or low chair.  Rides a walker or pedal car.  Can throw a large ball overhand 4-5 feet.
  • 23. FINE MOTOR:- • Fine motor development depends upon neural tract maturation. Fine motor development promotes adaptive activities with fine sensorimotor adjustments and include eye coordination , hand eye co ordination
  • 24. 15 Months  Builds a tower of 2-3 cubes.  Makes line with crayon.  Open boxes.  Begins to turn pages.
  • 25. 18 Months (1.5 Years)  Builds tower of 3-4 cubes.  Imitates a vertical stroke with crayon.  Turns pages in a book- 2 or 3 at a time.  Transfers objects hand to hand at will.
  • 26. 24 Months (2 Years)  Builds a tower of 6-7 cubes.  Imitates a circular stroke.  Imitates a horizontal stroke.  Turns pages of book one at a time.
  • 27. 36 Months  Builds a tower of 8 cubes.  Makes vertical and horizontal strokes but may or may not join them to make a cross.  Imitates circular stroke- forms closed figure.  Holds crayon with fingers instead of entire hand.
  • 28. SENSORY DEVELOPMENT • Sensory development depends upon myelinization of nervous system and responds to specific stimuli. Taste, smell, touch, and learning are initial senses present in newborn born babies. The visual system is the last to mature at about 6 to7 years. The other senses – hearing, taste, smell, and touch – continue to develop during toddler period.
  • 29. 15 Months  Sound localization by head movement in all planes.  Binocular vision fully developed.  Look at the pictures intently for prolonged periods of time.  Can identify geometric forms.
  • 30. 18 Months (1.5 Years)  Can see better, thus has intense interest in pictures.  Identifies various shapes.
  • 31. 24 Months (2Years)  Visual acuity: 20/40.  Accommodation well developed.
  • 32. 36 Months  Visual acuity: 20/30.  Recalls visual images.
  • 33. LANGUAGE, SPEECH DEVELOPMENT • 15 Months  Recognizes names of various parts of body.  Responds to familiar, simple commands.  Says 2-6 words.  Names familiar pictures or objects, such as ‘ball’.  Shakes head to communicate ‘no’.
  • 34. 18 Months (1.5 Years)  Identify one or more parts of body when named.  Identifies pictures of familiar objects when named.  Uses phrases composed of adjectives and nouns.
  • 35. 24 Months (2 Years)  Understand more complex sentences.  Enjoys stories with pictures.  Identifies four body parts when named.  Verbalize need for drink, food, or toileting.
  • 36. 36 Months  Identifies five body parts when named.  Gives full (first and last) name if asked.  Talks constantly.  Uses 4-5 word sentences.
  • 37. DEVELOPMENT THEORIES  Psychosocial development.  Psychosexual development.  Intellectual development.  Moral development.
  • 38. PLAY AND STIMULATION • DEFINITION:- • Play is the work of children. It consists of those activities performed for self amusement by which behavioral, social, and psychomotor changes takes place in the child.
  • 39. FUNCTIONS OF PLAY:- Play during the toddler period stimulates all areas of growth and development . Some of the more common functions of play to facilitate are: 1. Physical development. 2. Psychosocial development. 3. Cognitive development. 4. Moral development. 5. Language and Speech development.
  • 40. PLAY RESPONSES DURING THE TODDLER PERIOD:- • Play in the early toddler period is free and spontaneous. Play during the toddler period can be of various types : motor, creative, quiet, dramatic. • Motor play involves large muscles to push and pull toys and light furniture . Small muscles are used in block play, manipulation of materials, and self care skills. • Creative play is the manipulation of mud , sand, or clay as well as the use of crayons and finger paints. • Quiet activities are being read to, singing simple songs, and the arms in time to music.
  • 41. NEEDS OF TODDLERS • The basic needs of toddlers are for love and security, discipline leading to self control, progression to independence, and achievement of control of bodily functions. 1. Love and security :- Parental love should be constant, unconditional, and openly expressed, even when the child is misbehaving. This type of love enables the toddler to grow and to reach out for more mature goals. Both boys and girls give their first love to their primary care giver usually the mother. As their needs become more varied – less for physical care and more for socialization – their attachment to the father increases. When the father gives the same care as the mother, the infant generally feels attached to and secure with both parents.
  • 42. Contd. • During the toddler or early preschool period, the child may select an object that seems to provide security in the move from the small world of very early childhood. This security or transitional object, such as a blanket, diaper, toy, or an article of a parent’s clothing, gives the toddler a sense of control over the environment. The child may become distressed if the object is taken away to be cleaned or changed in any way.
  • 43. Contd. 2. Discipline leading to self control :- Discipline means establishing and adhering to standards of behavior for the toddler with the goal of self control. • Discipline is an essential way of preparing the child for adjustment to the world outside the home. • If it is to be constructive, discipline must help the child direct unacceptable, unrealistic, and often futile ways of attempting to reach a goal into effective, socially approved channels. • The way parents approach the problem of discipline is perhaps the best indication of their feelings toward their child.
  • 44. Contd. • Achieving control of bodily functions :- Achieving control of the bodily functions of defecation and urination is one of the major tasks of the toddler period. • The relative importance of this achievement depends on the culture and the socioeconomic status of the child’s family. • In some groups, toddlers do not wear diapers or pants and are permitted to move through the home and environment excreting at will. In these families, toilet training is not emphasized so the children in effect must train themselves.
  • 45. GROWTH, DEVELOPMENT, AND ACCIDENTAL INJURY • Increased mobility and ease of locomotion :- The development of gross motor skills enables the toddler not only to move farther more quickly by walking, running, climbing, and riding a tricycle but also to pull objects around and to explore areas like pools and ponds without the immediate supervision of an adult. Although the toddler can move around more easily, many of the skills of mobility are not refined, resulting in clumsiness and possible injury.
  • 46. Contd. • Improved fine motor control :- Because the smaller muscles of the body are increasingly under voluntary control, the toddler is able to manipulate objects; throw balls and other objects more forcefully; open containers, doors (refrigerator, cabinet and closet), gates, drawers, and some windows; explore holes and openings with fingers; and pull small parts from toys such as sewn-on button eyes from stuffed animals.
  • 47. Contd. • Heightened curiosity about the environment :- Toddlers are curious about everything in the environment, and they enjoy exploring whether they are supervised or not. Toddlers explore by putting objects into their mouth and possibly swallowing them. The toddler’s persistent exploration can very quickly lead to injury or death as a result of any of these accidents.
  • 48. Contd. • Increased sensitivity to the emotional climate of the home :- Any sudden change in a child’s environment, such as a new baby sitter, moving from one house or apartment to another, or going on vacation, can upset the routine of the home and predispose the child to accidental injury. The child’s hunger and fatigue at a time when the parents are busy, such as the hour before meals, late in the afternoon, or just before bedtime, can also result in accidental injury.
  • 49. ACCIDENT PREVENTION • Accidents are the largest single cause of mortality and disability between the ages of 1 and 4 years, claiming more victims than the six leading fatal distress combined. 1. Motor vehicle accidents. 2. Drowning. 3. Burns 4. Suffocation 5. Falls 6. Poisoning 7. Other types of injuries.
  • 50. HEALTH SUPERVISION • Health supervision visits are important during the toddler period to assess the toddler’s physical status and growth and development, to provide necessary immunizations, and to assist parents in resolving any concerns they may have. Visits are usually scheduled about every 4-6 months until 2 years of age and thereafter about once a year.
  • 51. Contd. • Immunizations :- During the second year, the toddler receives immunization against measles, mumps, and rubella; vaccination against H.influenzae type b is also recommended. • Dental Health :- To prevent the dental diseases, children not only must eat an adequate, low-cariogenic diet but also be protected by good daily oral hygiene, regular dental supervision, and the use of fluorides and pit-and-fissure sealants.