DEVELOPMENTAL MILESTONE

DEVELOPMENTAL THEORIES
PSYCHOSEXUAL DEVELOPMENTAL THEORY
Sigmund Freud considered sexual instincts to be significant in the development of personality. At each stage, regions of the body assume prominent psychologic significance as sources of pleasure. Gratification or pleasure shift from one zone of the body to another. From the mouth to anus then to the genitals.

PSYCHOSEXUAL THEORY
ORAL (BIRTH 1 YEAR)
Babys chief source of pleasure is the MOUTH.
Infants sucks for the enjoyment as well as nourishment. Gains gratification by swallowing, chewing, biting and eating. Unable to delay gratification. Begins to develop self-concept from the responses of others.

PSYCHOSEXUAL THEORY
ANAL (1 3 YEARS)
Zone of gratification is ANUS/BUTTOCKS.

Child derives sensual satisfaction from withholding and expelling feces.

Bladder and bowel training occurs 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.

PSYCHOSEXUAL THEORY

TOILET TRAINING
Readiness is 18-24 months. Bowel training accomplished before bladder. Complete night bladder training at 4 or 5-years-old.

SIGNS OF TODDLERS 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.

PSYCHOSEXUAL THEORY
PHALLIC (3 6 YEARS)
The childs pleasure centers on the GENITALIA and masturbation. Time of Family Romance A. Oedipal Complex - This is marked by jealousy and rivalry toward the same sex parent and love of the opposite sex. - Seen in boys. B. Electra Complex - Seen in girls. 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.

PSYCHOSEXUAL THEORY

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.

PSYCHOSEXUAL THEORY
GENITAL ( 12 YEARS AND 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 adolescents need for sexual satisfaction and societys expectations for control of sexual expression. Core concerns are body image development and acceptance of the opposite sex.

PSYCHOSOCIAL THEORY

Erik Erikson believed that development results from social aimsor conflicts arising from feelings, parent-child interaction, and social relationships.
At each stage, children confront a crisis that requires the integration of personal needs and skills with social and cultural expectations. Each stage has two components, favorable and unfavorable.

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 Infants who receive attentive care learn that life is predictable and that their needs are promptly meet. MISTRUST Infants whose needs are consistently unmet or who experience significant delays develop a sense of uncertainty.

TRUST vs MISTRUST (BIRTH 1 YEAR)

PSYCHOSOCIAL VIRTUE: HOPE FEARS: Stranger anxiety; loud noises, falls, sudden movement in the environment. PLAY: SOLITARY (non-interactive), reflect development and awareness of the environment. AGE APPROPRIATE TOYS - safe, no sharp edges, not small, non-detachable parts Birth 3 months: mobiles, mirrors, music boxes, rattles,stuffed animals without detachable parts 4-6 Months: squeeze toys, busy boxes and play gyms 7-9 Months: cloth-textured toys, splashing toys, large blocks and large balls 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

AUTONOMY vs SHAME AND DOUBT (1-3 YEARS)

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 - safe, non-detachable, no small parts Dolls and housekeeping toys Play phones and cloth books 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 parents social consciousness Child develops initiative when trying out new things and is not overwhelmed by failure.

INITIATIVE vs GUILT (3-6 YEARS)

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 Tricycle, big wheels, gym sets, wading pools and sandboxes to enhance gross motor skills. Large blocks, puzzles, crayons, paints and simple crafts to enhance fine motor skills 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 Increasing complex board and card games Book and crafts Music and art Athletic activities( swimming), team activities, video games

IDENTITY vs IDENTITY CONFUSION (12-18 YEARS)

ADOLESCENCE
Adolescent determines own sense of self. Development of who, what, and where they are going become focus (SELF-CONCEPT) 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 generationor 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 - 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.

PRINCIPLES OF COGNITIVE DEVELOPMENT

1. ORGANIZATION

- is the tendency to create systems that bring together all of a persons knowledge of the environment. - development progresses from simple organizational structures to more complex ones.

2. ADAPTATION - how a person deals with new information.

- it occurs through the process of assimilating new information and accommodating it.

PRINCIPLES OF COGNITIVE DEVELOPMENT

a. ASSIMILATION
- is the attempt to fit new information into an existing cognitive structure.

b. ACCOMMODATION

- is a change in an existing cognitive structure to cope with new information or new situation or new situation.

EQUILIBRATION

- is the tendency to strive for a state of mental balance (equilibrium) both between a person and the outside world and among the cognitive elements within a person.

PIAGETS 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.

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.

SUBSTAGE 2 ( 1-4 MONTHS ) PRIMARY CIRCULAR REACTIONS

Marked by stereotyped repetition and the infants focus on his own body as the center of interest.(e.g. infant discovers own body parts) FOCUS: Infants body Hand-mouth and ear-eye coordination develop. Development of primary circular reaction to acquired adaptation then finally organization. Enjoyable activity for this period: a rattle or a tape of parents voice. NO object permanence.

SUBSTAGE 3 ( 4-8 MONTHS )

SECONDARY CIRCULAR REACTIONS
Infants learns to initiate, recognize and repeat pleasurable experiences from environment.

Coincides with new interest to manipulate objects in the environment.

Memory traces are present; infants anticipates familiar events. Actions intentional but not initially goal-directed. Begin to show partial object permanence. Good toy for this period: mirror Good game: peek-a-boo

SUBSTAGE 4 ( 8-12 MONTHS)

COORDINATION OF SECONDARY SCHEMES

Behavior is more deliberate and purposeful as infants 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. Good toy: nesting toys (colored boxes)

SUBSTAGE 5 ( 12-18 MONTHS )

TERTIARY CIRCULAR REACTIONS
Infants show curiosity as they purposely vary their actions to see results. Child is able to experiment to discover new properties of objects and events. Try new activities and use trial and error in solving problems. Object permanence developed further. (Follow series of displacements and look in last place rather than first.) Good game: throw and retrieve

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. 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.

PREOPERATIONAL STAGE 1. PRECONCEPTUAL PHASE ( 2-4 years )

The child forms concepts that are less complete and logical than adult concepts. - Centration, conservation of matter(height & weight), reversibility and 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.

PREOPERATIONAL STAGE

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 deductivereasoning, 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 : Idealism (perfect word) Egocentism (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. This 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 Ill scratch yours. - Ill 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.

II. CONVENTIONAL MORALITY ( 10 13 YEARS)

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 ones duty. A law should be obeyed even if its 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.

III. POST-CONVENTIONAL MORALITY ( 13 YEARS,OR UNTIL YOUNG ADULTHOOD, OR NEVER )

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 irregardless 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

DEVELOPMENT
- maturation of structures. - includes growth and is a process that continues over time.

GROWTH

- increase in size of a structure. - Human growth is orderly and predictable, but not even. It follows a cyclical pattern.

CRITICAL PERIOD - specific time period during which certain environmental events or
stimuli have greatest effect on childs development.

RATES OF GROWTH AND DEVELOPMENT

Growth and development are not synonymous but are not closely interrelated processes directed by both genetic and environmental factors.

INFANCY AND ADOLESCENCE - fast growth periods. TODDLER THROUGH SCHOOL-AGE FETAL PERIOD, INFANCY AND ADOLESCENCE - the trunk grows more rapidly than other tissues. SCHOOL-AGE PERIOD - limbs grow most.
- slow growth periods.

GROWTH AND DEVELOPMENT ( 1 MONTH )

PHYSICAL
WEIGHT Gains about 150-210 g (5-7 oz.) weekly during the first 6 months of life. Birth weight doubles by 5-6 months. Triples by 12 months. HEIGHT Grows about 2.5 cm (1 inch) a month for the first 6 months of life. HEAD CIRCUMFERENCE/OCCIPITO-FRONTALCIRCUMFERENCE (OFC) Grows about 1.5 cm (1/2 inch) a month for the first 6 months. CHEST CIRCUMFERENCE Normally about 1 inch (2cm) less than HC. Measure chest circumference at the level of the nipples.

GROWTH AND DEVELOPMENT ( 1 MONTH )

PHYSICAL

FONTANELLE
At birth, anterior fontanelle measures about 2 inches (4-5 cm) at its widest part; closes at between 12-18 months. At birth, posterior fontanelle measures 0.5 inches (0.5-1cm) at its widest part; closes by 2 months of age.

MOTOR
Holds the head parallel from the body when suspended in prone position. Can turn head from side to side when prone; lifts head momentarily from bed. Asymmetric posture dominates, such as tonic neck reflex. Primitive reflexes still present.

GROWTH AND DEVELOPMENT ( 1 MONTH )

SENSORY
Eye movements coordinated most of the time; follows a light to midline. Visual acuity 20/100 to 20/50

SOCIALIZATION AND VOCALIZATION

Watches face intently while being spoken to. Utters small, throaty sounds.

GROWTH AND DEVELOPMENT ( 2 3 MONTHS )

PHYSICAL
MOTOR

Posterior fontannel closed.

Holds head erect for a short time and can raise chest supported on forearms. Bears some weight on legs when held in standing position. Actively holds rattle but will not reach for it. Grasp, tonic neck, and Moro reflexes are fading, step or dance reflex disappears. Play with fingers and hands.

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 because salivary glands are functioning but dont have sufficient coordination to swallow.

MOTOR

Can sit when the 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 the whole hand but misjudges distance. Can carry hand or object to the mouth at will. Primitive reflexes(grasp, tonic neck and Moro) have disappeared.

GROWTH AND DEVELOPMENT ( 4-5 MONTHS)

SENSORY
Recognizes familiar objects and people. Accommodation is developing.

SOCIALIZATION AND VOCALIZATION

Coos and gurgles when talked to; enjoys social interaction. Vocalizes displeasure when an object is taken away.

GROWTH AND DEVELOPMENT ( 6-7 MONTHS)

PHYSICAL
WEIGHT Gains about 90 to 150 g (3-5 oz) weekly during second 6 months of life. HEIGHT Grows about 1.25 cm (1/2 inch) a month.

HEAD CIRCUMFERENCE Grows about 0.5 cm (1/5 inch) a month. Teething may begun eruption of two lower central incisors, followed by upper incisors.

GROWTH AND DEVELOPMENT ( 6-7 MONTHS)

MOTOR

Can turn equally well from stomach or back Sits fairly well unsupported, esp. if placed in forward-leaning position. Lifts head off table when supine Can approach a toy and grasp it with one hand; can transfer a toy from one hand to the other and from hand to mouth. Plays with feet and puts them in mouth.

SENSORY

Has taste preferences; will spit out disliked food Begins to recognize things are still present even though not seen.

GROWTH AND DEVELOPMENT ( 6-7 MONTHS)

SOCIALIZATION AND VOCALIZATION

Begins to differentiate between strange and familiar faces and shows Stranger Anxiety. Makes polysyllabic vowel sounds. Vocalizes m-m-m-m when crying; cries easily on slightest provocation but laughs just as quickly.

GROWTH AND DEVELOPMENT ( 8-9 MONTHS )

MOTOR

Sits steadily alone; pulls self to standing position; stands holding onto furniture. Has a good hand-to-mouth coordination. Developing pincer grasp, with preference for use of one hand over the other. Crawls, may go backward at first.

SENSORY

Depth perception is increasing. Displays interest in small objects.

GROWTH AND DEVELOPMENT (8-9 MONTHS)

SOCIALIZATION AND VOCALIZATION

Define social attachments is evident; shows anxiety with strangers. Responds to own name; is separating from mother by desire to act on own. Reacts to adult anger and cries when scolded. Has imitative and repetitive speech using vowels and consonants such as Dada and Mama No true as yet but comprehend words such as BYE-BYE

GROWTH AND DEVELOPMENT ( 10-12 MONTHS )

PHYSICAL
WEIGHT Birth weight triples. HEIGHT Birth length increases by 50% Head and chest circumference are equal. Upper and lower and lateral incisors usually have erupted for total of 6-8 teeth. Hemotocrit: 29-41%

GROWTH AND DEVELOPMENT ( 10-12 MONTHS )

MOTOR

Creeps (abdomen off the floor) Stands alone for short times; walks with help; moves around by holding onto furniture. Can sit down from a standing position without help. Can eat a spoon and cup but needs help; prefers using fingers. Can play pat-a-cake and peek-a-boo; holds a crayon to mark paper Helps in dressing (e.g. putting an arm through sleeve)

SENSORY

Visual acuity 20/50 Discriminates simple geometric forms.

GROWTH AND DEVELOPMENT ( 10-12 MONTHS )

SOCIALIZATION AND VOCALIZATION
Shows emotions such as jealousy,affection and anger. Enjoys surroundings and will explore away from mother. Fearful in strange situations or strangers; clings to mother. May develop security blanket. Can say two words besides DADA or MAMA with meaning Understands simple verbal requests (e.g. Give it to me.

FEEDING MILESTONES DURING INFANCY

At birth, the full-term infant has sucking, rooting and swallowing reflexes. Newborn feels hunger and indicates desire for food by crying; expresses satiety by falling asleep. At 1 month, has strong extrusion reflex. By 5-6 months, can use fingers to eat teething crackers or toast. By 6-7 months, developmentally ready to chew solid foods. By 8-9 months, can hold a spoon and play with it during feeding. By 9 months, can hold own bottle. By 12 months, can drink from cup with some spilling at times bottle is still preferred.

ACCIDENT PREVENTION DURING INFANCY

NEWBORN INFANT
Dont smoke around infants. Dont leave infant unattended in a high place or unstrapped in a safety seat. Use rear-facing car safety seat. Make sure furniture is free of lead-based paint. Crib slats should be no further than 2 3/8 inches; the mattress and bumper pads should be tight fitting.

ACCIDENT PREVENTION DURING INFANCY

2 MONTHS

Dont hold infant while smoking or drinking hot liquid. Set water heater at 120F-130F; Test bath water with inner aspect of the wrist before immersing infant.

4 MONTHS

Keep small objects and small pieces of food out of infants reach. Dont use teething biscuits- they may become small and obstruct airway.

6 MONTHS

Child-proof the home,esp. the kitchen and bathroom. Remove all dangerous items or place out of reach. Use syrup of ipecac in home for emergency use. Keep poison control number on phone; use as needed.

ACCIDENT PREVENTION DURING INFANCY

9 MONTHS

Use nonskid rugs, socks with nonskid strips, nonskid strips in bathroom. Keep wastebaskets covered or out of reach. Pad sharp edges of furniture. Never leave unattended near water or in bathtub. Dont use electrical appliances near water.

1 3 YEARS OLD

Dont use toys with small pieces. Hold childs hand when walking near the street. Encourage the child to sit down while eating. Turn pot handles toward the back of the stove. When 20 lbs use front-facing car seat.

GROWTH AND DEVELOPMENT ( 15 MONTHS )

MOTOR

Walks well alone by 14 months with a wide-based gait; creeps upstairs. Builds tower of two blocks; enjoys throwing 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.

GROWTH AND DEVELOPMENT ( 18 MONTHS )

PHYSICAL

Growth has decreased and appetite lessened- PHYSIOLOGIC ANOREXIA Anterior fontanel is usually closed. Abdomen protrudes, larger than chest circumference

MOTOR

Runs clumsily; climbs stairs or up on furniture. Imitates strokes in drawing. Drinks well from cup; manages a spoon well. Builds tower of three to four cubes

GROWTH AND DEVELOPMENT ( 18 MONTHS )

V0CALIZATION
Says 10 or more words. Has a new awareness of strangers. Begins to have temper tantrums. Very ritualistic, has a favorite toy or blanket, thumb sucking may be at peak.

GROWTH AND DEVELOPMENT ( 2 YEARS )

PHYSICAL
WEIGHT About 11-12 kg (26-28 lbs) HEIGHT About 80-82 cm (32-33 inches) TEETH 16 temporary; begin visits to dentist

MOTOR

Gross motor skills quite refined. Can walk up and down stairs, both feet on one step at a time, holding onto rail. Builds tower of six to seven cubes or will make cubes into a train.

GROWTH AND DEVELOPMENT ( 2 YEARS )

SENSORY
Accommodation well developed. Visual acuity 20/40

VOCALIZATION AND SOCIALIZATION

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 tower of eight blocks. Copies horizontal or vertical line. May attend to own toilet needs.

GROWTH AND DEVELOPMENT ( 30 MONTHS )

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.

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 ( 30 MONTHS )

PROCESS OF BOWEL TRAINING Usually begins with bowel then bladder. Accidents and regressions frequently occur
PARENTAL GUIDANCE Choose a specific word for the act. Have a specific time and place. Do not punish for the accidents. DISCIPLINE Be consistent; set realistic limits. Reinforce desired behavior. Be constructive, geared to teach self-control. Punish immediately after wrongdoing; punish appropriately.

GROWTH AND DEVELOPMENT ( 3 YEARS )

PHYSICAL

Usual weight gain 1.8 to 2.7 kg (4-6 lbs) Usual height gain 7.5 cm (3 inches)

MOTOR

Jumps off bottom step; walks upstairs alternating feet. Rides a tricycle using pedals. Constructs three-block bridge; builds tower of 9-10 cubes. Can unbutton front or side button; uses a spoon. Usually toilet trained at night.

SENSORY

Visual acuity 20/30.

GROWTH AND DEVELOPMENT ( 3 YEARS )

VOCALIZATION AND SOCIALIZATION

Vocalization of about 900 words; uses three-to-four word sentences; uses plurals; may have hesitation in speech pattern. Begins to understand ideas of sharing and taking turns.

MENTAL ABILITIES

Beginning understanding of the past, present and future, or any aspect of time. Stage of magical thinking.

GROWTH AND DEVELOPMENT ( 4 YEARS )

PHYSICAL
Height and weight increases are similar to previous year. Length at birth is doubled

MOTOR
Skips and hops on one foot; walks up and down stairs like an adult. Can button buttons and lace shoes. Throws ball overhand; uses scissors to cut outline.

GROWTH AND DEVELOPMENT ( 4 YEARS )

VOCALIZATION AND SOCIALIZATION
Vocabulary of 1500 words or more. May have an imaginary companion. Tends to be selfish and impatient but takes pride in accomplishments; exaggerates,boasts, and tattles on others.

MENTAL ABILITIES
Unable to conserve matter. Can repeat four numbers and is learning number concept. Knows which is the longer of two lines; has poor space perception.

GROWTH AND DEVELOPMENT ( 5 YEARS )

PHYSICAL
Height and weight increases are similar to previous year.

MOTOR

Gross motor abilities well developed; can balance on one foot for about 10 seconds; can jump rope, skip, and roller skate. Can draw a picture of a person; prints first name and other words as learned. Dresses and washes self; may be able to tie shoelaces.

GROWTH AND DEVELOPMENT ( 5 YEARS )

SENSORY
Color recognition is well established.

VOCALIZATION AND SOCIALIZATION

Vocabulary of about 2100 words; talks constantly; ask meaning of new words. Generally cooperative and sympathetic toward others. Basic personality structure is well established.

GROWTH AND DEVELOPMENT ( 5 YEARS )

MENTAL ABILITIES (PIAGETS PHASE OF INTUITIVE THOUGHT)

Beginning understanding of time in terms of days as part of a week. Has not mastered the concept that parts equal a whole regardless of their appearance; difficulty with abstract thought.

ACCIDENT PREVENTION (3-5 YEARS)

Use bicycle helmet; ride bicycle on right-hand side of the road or on sidewalk; make sure the bicycle is the correct size, feet should touch the ground when sitting on the bicycle seat. Teach child not to eat things from outside (e.g. mushrooms) until checked by parents. Look both ways before crossing street. Use safety restraints in cars.

GROWTH AND DEVELOPMENT ( 6-12 YEARS )

PHYSICAL GROWTH
Permanent dentition, beginning with 6-year molars and central incisors at 7 or 8 years of age. Tends to look lanky because bone development precedes muscular development. 6 years: height and weight gain slower, 2 and 2 3 kg (4 to 6 lb) a year. 7 years: continues to grow, 5 cm (2 inches) and 2.5 kg (5 lb) a year. 8 to 9 years: continues to grow, 5 cm (2inches) and 3 kg (6 lb) a year 10 12 years: slow growth in height compared to rapid weight gain, 6.25 cm (2 inches) and 4.5 kg (10 lb) a year; pubescent changes may begin to appear, especially in females.

GROWTH AND DEVELOPMENT ( 6-12 YEARS )

MOTOR
Refinement of coordination, balance, and control occurs Motor development necessary for competitive activity becomes important.

SENSORY
Visual acuity of 20/20.

GROWTH AND DEVELOPMENT ( 6-12 YEARS )

MENTAL ABILITIES
Readiness for learning, especially in perceptual organization: names months of the year, knows right from left, can tall time, can follow several directions at once. Acquires use of reason and understanding of rules; needs consistency. Trial-and-error problem solving becomes more conceptual rather than action oriented. Reasoning ability allows greater understanding and use of language. Concrete operations (Piaget): knows that quantity remains the same even though appearance differs.

ACCIDENT PREVENTION (6-12 YEARS)

Obey traffic signals while on bike; use reflectors on bike; wear light clothing. When playing group sports look for teams divided by size and maturation, not by age; use protective equipment.

GROWTH AND DEVELOPMENT ( ADOLECENCE )

PHYSICAL
Includes the physical changes associated with puberty such as secondary sexual characteristics.

PUBERTAL GROWTH SPURT FEMALES BETWEEN 10 AND 14

Weight gain 7-25 kg (15-55 lb), mean 17.5 kg (38 lb) Approximately 95% of mature height achieved by the onset of menarche or skeletal age of 13 years; height gain 5 to 25 cm (2-10 inches), mean 20.5 cm (8 inches)

MALES BETWEEN 12 AND 16 YEARS

Weight gain 7-30 kg (15-65 lb), mean 23.7 kg (52 lb) Approximately 95% of mature height achieved by skeletal age of 15 years Height gain 10-30 cm (4-12 inches), mean 27.5 cm (11 inches).

GROWTH AND DEVELOPMENT ( ADOLECENCE )

MENTAL ABILITIES
ABSTRACT THINKING - New level of social communication and understanding: can comprehend satire and double meanings; can say one thing and mean another. - Can conceptualize thought; more interested in exploring ideas than facts. - Can appreciate scientific thinking, problem solve, and theoretically explore alternatives. PERCEPTION - Can appreciate nonrepresentational art. - Can understand that the whole is more than the sum of its parts. LEARNING - Long attention span. - Learns through inference, intuition and surmise rather than repetition and imitation. - enjoys regressing in terms of language devt. by using jargon to suit changing moods.

ACCIDENT PREVENTION ( ADOLECENCE )

Use car safety restraint. Teach responsible behavior to reduce sexually transmitted diseases. Suicide prevention. Handgun control and safety. Motorcycle helmet use. Smoke and carbon monoxide detector use.

ACCIDENT PREVENTION (ELDERLY)

At risk for injuries - Muscle weakness. - Changes in balance. - Gait abnormalities. - Slowed reaction time. - Use of medications. - Chronic medical conditions (Parkinsons disease) - Changes in vision, hearing, smell Remove throw rugs, door thresholds; make sure floors are smooth and non slip. Clear pathways of furniture. Use solid chairs with arm rests. Provide good lighting with accessible switches; use night light. Adapt kitchen and bathroom; use raised toilet seat, grab bars. Use cordless phone.