Care routines-for-children

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  • Encourage the child who has noticed what they have done after the event. “Yes that’s Michael’s wee – he did it on the e floor. Maddie, are you telling me your nappy is uncomfortable? You did pooh. You want children to feel you welcome them telling you. If you make them feel bad or embarrassed they may avoid the signs that help them to develop control or have their self esteem damaged. Make the bathroom or potty area a bright and interesting place. Allow childfren to play with a clean potty or sit on it whenever they wish, An advantage of toilet training in child care is that they often wish to copy the other children.
  • Involving children in the parts of the toilet routine they can manage themselves ie pulling down their own pants, washing hands or flushing the toilet. Provide easily-removed clothes and encourage parents to do so as well. In warm weather, just wearing training pants is best. Being in pants helps toddlers become aware of being wet or soiled.
  • Once children have accomplished these tasks, they are able to care for their own toileting needs. There is usually no need for structures toileting routine or times when adults direct all children to go to the toilet. However, to support children’s independence, it is necessary to have have equipment that is easily accessible to the children and that allows them to act independently How?? Able to reach toilets, taps and towels, easy clothing,enough toilets to seat several children at once time.
  • Accidents are normal and need to be dealt with in a matter-of-fact way. Caregivers should try to help families tp see it this way. This is an issue that needs to be discussed with new families when they are being intorduced to the group setting.
  • In cultures where infants are carried close to an adult’s body, sleep with parents or if washing soiled clothing is a problem, people have developed other ways of handling elimination. A common practice is “holding out”. This refers to the practice of removing an infant’s clothing and holding him or her away from the caregiver’s body or over a potty at the appropriate time. This practice is only effective if caregivers are in close physical contact with the infant at the time i.e. cultures that carry infants on their backs. These caregivers b4ecome sensitive to the infant’s elimination pattern and the cues they use to indicate they are about to empty their bladder or bowel. In the Artic North America, traditional Inuit mothers do this as there is a real danger to infants if their urine freezes in their clothes This used to be common in many Australian , European and Asian families. “ Holding out” does not assist the child to become independent. The caregiver becomes trained to watch and catch what the child produces and the child is mostly oblivious to the process The practice of “holding out” has strongly influenced many attitudes to toilet training. Beliefs about lack of control being dirty or bad, result in parents being faced with emotive and stressful situations. Parents who understand the developmental issues involved in the process may be pressured or criticised by grandparents or other people for seemingly lax attitudes to their responsibilities. Caregivers can help by supporting parents.
  • Care routines-for-children

    1. 1. CHCCN302A ProvideCare for Children CHC30708 Certificate 111 Children’s Services
    2. 2. Care for Toddlers’ Toileting Needs <ul><li>To become independent in toileting, children must be developmentally ready both physically and emotionally. </li></ul><ul><li>They can be ready any time from 18 months to 4 years and there is always at least one Mum who will boast that her child was toilet trained earlier! </li></ul>
    3. 3. Signs of Independence <ul><li>Recognise and communicate the need to go </li></ul><ul><li>Walk to toilet or potty </li></ul><ul><li>Undress to some extent and then manage toileting procedure </li></ul><ul><li>This is a HUGE task! </li></ul>
    4. 4. <ul><li>Process of control involves learning to recognise the feeling of wanting to go </li></ul><ul><li>Also requires some control of muscles that govern the opening and closing of the anus and urethra (sphincters) </li></ul><ul><li>This is a maturational process and until particular nerve pathways have developed, control is not possible </li></ul>
    5. 5. <ul><li>Usually girls will learn control earlier than boys </li></ul><ul><li>This may be because girls have fewer muscles involved in bladder and bowel control than boys </li></ul><ul><li>Some children are mature enough to achieve full control by 2 years, some by 3 or beyond </li></ul><ul><li>Caregivers should expect uneven development as maintenance of control is vulnerable to illness, emotional disturbance and changes in routine. </li></ul>
    6. 6. Signs of Readiness for Toilet Training <ul><li>Child indicates an understanding of wet and dry nappies </li></ul><ul><li>Longer intervals between wet nappies – when you change the nappy it is completely dry or suddenly absolutely soaked through </li></ul><ul><li>Being regular with bowel motions i.e. after breakfast </li></ul><ul><li>Showing increased interest in passing urine or a motion </li></ul><ul><li>Wanting to copy other children </li></ul>
    7. 7. Toilet readiness cont’d <ul><li>Can pull own pants up and down </li></ul><ul><li>Makes a physical demonstration when having a bowel movement i.e. squatting down, grunting, telling you </li></ul><ul><li>Has words for stool and urine </li></ul><ul><li>Can follow simple instructions </li></ul>
    8. 8. Toilet readiness cont’d <ul><li>Understands the physical signals that mean he has to go and can tell you </li></ul><ul><li>Demonstrates a desire for independence </li></ul><ul><li>Can walk and sit down </li></ul><ul><li>A realisation that he/she can have some control over elimination </li></ul>
    9. 9. Assisting children with toilet learning <ul><li>QIAS documentation states that : </li></ul><ul><li>Toileting and nappy changing are positive experiences. There is a positive approach to toddlers’ abilities in toileting </li></ul>
    10. 10. Assisting children with toilet learning <ul><li>Caregivers can ensure that it is a positive experience for toddlers by: </li></ul><ul><ul><li>Following where possible, the toileting learning practices that the child is familiar with at home </li></ul></ul><ul><ul><li>Giving recognition, positive responses and encouragement </li></ul></ul><ul><ul><li>Use words parents use at home or correct terms and describe what is happening. </li></ul></ul>
    11. 11. Positive responses <ul><li>Showing interest in what is happening </li></ul><ul><li>Never show disgust or treat what child is doing as ‘dirty’. </li></ul><ul><li>Encourage the child who has noticed what they have done after the event </li></ul><ul><li>Make the bathroom or potty area a bright and interesting place. Allow children to play with a clean potty or sit on it whenever they wish </li></ul>
    12. 12. <ul><li>Involving children in the parts of the toilet routine they can manage themselves ie pulling down their own pants, washing hands or flushing the toilet. </li></ul><ul><li>Provide easily-removed clothes and encourage parents to do so as well. In warm weather, just wearing training pants is best </li></ul><ul><li>Never hurry or put pressure on a child. Your role is to help but it is the child who controls the process </li></ul>
    13. 13. <ul><li>Showing interest and recognisng the child’s pride in what they produce. Discourage handling faeces but accept that exploring is natural and common. Do not over-react </li></ul><ul><li>Make sure that the potty, potty chair or toilet seat is comfortable, stable and safe. Secure steps or hand rails may be needed for adult-sized toilets </li></ul>
    14. 14. <ul><li>Have regular toilet times to remind children they need to go and to give learners the role model of other children using the toilet </li></ul>Nurse with children – their toilet outine.  UNRRA Children's Center, Aglasterhausen, Germany, 1945
    15. 15. Accidents will happen.. <ul><li>In learning bladder and bowel control there can be setbacks. If the child becomes stressed or ill, it may be possible, with the parents’ permission to go back to nappies </li></ul><ul><li>Help the child to understand why he/she has lost control and be very aware of maintaining his/her self-esteem. </li></ul><ul><li>Nappies should never be used as a threat or a punishment. Even adults have accidents and some people with disabilities never have control. </li></ul>8/28/2005 CHCCN2C Care For Children
    16. 16. 8/28/2005 CHCCN2C Care For Children Older children who have accidents will feel better about cleaning up after themselves. Encourage their efforts.
    17. 17. Attitudes to toilet learning <ul><li>Attitudes to elimination, body wastes and parts of the body are complex, emotive and varied. In assisting children develop awareness and competence in managing their needs, it is important to be open and honest when giving them information. </li></ul><ul><li>On the other hand, you should be sensitive and aware of differing family and cultural beliefs about these subjects. </li></ul>
    18. 18. Responding to toileting accidents <ul><li>By 3 years of age, many children will have achieved independence in toileting and be able to: </li></ul><ul><ul><ul><li>Verbalise toileting needs </li></ul></ul></ul><ul><ul><ul><li>Control both the bladder and bowels during the day without many accidents </li></ul></ul></ul><ul><ul><ul><li>Pull pants and underpants up and down, but will still need help with buttons and other fasteners </li></ul></ul></ul><ul><ul><ul><li>Wash hands but need supervision with drying </li></ul></ul></ul>
    19. 19. <ul><li>Some children may still need extra support with toileting. </li></ul><ul><li>Caregiver’s role is to provide encouragement and sometimes gentle reminders </li></ul><ul><li>Avoid drawing attention to toileting accidents – can make children embarrassed, pressured or ashamed. </li></ul><ul><li>Accidents are normal and need to be dealt with in a sensitive and matter-of-fact way. Try to help families realise this </li></ul><ul><li>Keep spare clothes handy and ask parents to send extra clothes if necessary. </li></ul>8/28/2005 CHCCN2C Care For Children
    20. 20. <ul><li>Most toileting accidents commonly occur during rest time </li></ul><ul><li>Remaining dry while sleeping is a skill some children may still be mastering </li></ul><ul><li>Quietly reassure child that accidents happen and that it is all right. </li></ul><ul><li>Be sensitive to the fact that some children will not only be disappointed with themselves, but ,ay be concerned with others’ reactions. </li></ul><ul><li>Try to be discreet and provide child with privacy to change clothes. </li></ul>8/28/2005 CHCCN2C Care For Children
    21. 21. Cultural Differences <ul><li>Families and cultural groups have differing beliefs and expectations about how and when bowel and bladder control is achieved. </li></ul><ul><li>Some leave children to develop at their own pace, but environmental conditions make this impractical some places. </li></ul><ul><li>In hot climates and for people who spend most of the time outdoors, when and where children eliminate is usually not a problem. Adults and children often relieve themselves in the open, providing a role model for children to become aware and develop control. </li></ul>8/28/2005 CHCCN2C Care For Children
    22. 22. Cultural Differences cont’d <ul><li>“ Holding out” </li></ul><ul><li>“ Holding out” does not assist the child to become independent. The caregiver becomes trained to watch and catch what the child produces and the child is mostly oblivious to the process </li></ul><ul><li>The practice of “holding out” has strongly influenced many attitudes to toilet training. </li></ul><ul><li>Beliefs about lack of control being dirty or bad, result in parents being faced with emotive and stressful situations </li></ul><ul><li>Caregivers can help by supporting parents </li></ul>
    23. 23. Homework task <ul><li>Find out as much as you can about different approaches to toilet training. Talk to parents or experienced caregivers or read about it online or in books recommended for this unit. </li></ul><ul><li>See handout sheet with suggested websites </li></ul>
    24. 24. Routines to develop skills <ul><li>Use caregiving routines to create opportunities for caregivers to spend one on one time with children to develop relationships. </li></ul><ul><li>Use routines to develop language as well as self-help skills. Talk to children. </li></ul><ul><li>Activity </li></ul>
    25. 25. Providing food & drink for toddlers <ul><li>Toddlers express their likes and dislikes for food and drink very strongly </li></ul><ul><li>Their growth rate is beginning to slow and caregivers notice that children may not want to eat as much as they did in the past </li></ul><ul><li>Toddlers may be labelled as ‘fussy eaters” </li></ul>

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