Average achievements of a toddler 18 months

PHYSICAL
Anterior fontanel closed - may be closed as early as 12
months
Abdomen protrudes
Physiological anorexia due to decreased growth
Has sphincter control
MOTOR
Walks-seldom falls-sideways and backward
Can walk upstairs holding with one hand
Can attempt jumping
4/25/2013 St.Phn MBARUKU SAID

 Sits self in small chair
 Climbs on furniture
 Gets into everything, explores drawers even
waste baskets
 Pushes light furniture around room
 Throws ball overhead without falling
 Scribbles vigorously
 Turns pages in a book
 Can put things into a hole

 SELF CARE
 Holds cup with both hands and can hand it to
care giver, put it down or drops it.
 Eats with spoon and turns spoon in mouth
 Spills frequently
 May play with food
 Negativism and high activity level
 May interfere with eating

 Removes and unzips simple garments
 Complains when wet
 May indicate need to toilet
 Increased readiness for bowel and bladder
control
 May control bowel movement
 May smear feces

 SENSORY
 Intense interest in pictures
 Identifies various shapes

 PSYCHOSOCIAL
 Sense of autonomy (a feeling of independence)
 Egocentric
 Autonomous behavior increasing
 Negativism and dawdling predominant
 Have temper tantrums
 Aware of strangers

 Seeks help when in trouble
 May resist to sleep for sometime
 Bed rituals begins
 Imitates parents behavior
 Possessiveness begins
 Gender identity begins

 INTELLECTUAL
 Is comfortable when hearing parents voice
 Short attention span
 Begins sense of time and anticipation of events
 Begins to think
 Beginning traces of memory
 Experiments actively to achieve goals

 LANGUAGE
 Speaks an average of 10 real words
 Name pictures
 Uses words than gestures to express desire
 About 25% of vocalization is intelligible

 PLAY STIMULATION
 Enjoys solitary play or watching activities of
others
 Has a favorite toy

 Provide:
 For motor play
 Large hollow wooden blocks
 Balls
 Pull toys
 Low swing with arms and back
 Low slide
 Rocking chair or horse
 Low wheeled toys to ride
 Small chair and table
 Running and chasing games

 For creative play
 Container with openings into which blocks of
different shapes can be placed
 Blocks, bowls, tumblers
 Finger paints
 Large crayon
 Clay
 Bells around wrist or ankle
 Sand toys (shovels, pail)
 Stuffed animals and dolls to drug, sit upon or hug
 Imitates parental actions in play

 PHYSICAL
 Weight approximately 11.8-12.7 kg
 Height approximately 82.5 -85 cm
 Gained 10 -12 cm in second year
 Adult height is about twice height at 2 years
 Chest circumference exceeds head circumference
 Anterior posterior diameter less than lateral
diameter
 Head circumference 49-50 cm
 Pulse 110 + 20 –average 100 beats/minute

 Respiration 26-28/minute
 Blood pressure 99/64 + 26/24
 Landau reflex completely disappeared
 Approximately has 16 temporary teeth
 Physiologic function is mature except
endocrine and reproductive
 Abdomen protrudes less than in 18 months
 May control daytime bowel and bladder

 MOTOR
 Can walk with heel toe gait
 Walks backwards in imitation
 Runs more quickly with few falls
 Jumps
 Kicks large ball
 Builds tower of 6-7 cubes
 Makes cubes into a train
 Turns pages of a book one at a time
 Opens door by turning knob
 May run away
 Unscrews lid or jar
 Folds paper once (imitating)

 SELF CARE
 Drinks well from a small glass held in one hand
 Puts spoon in mouth occasionally with one hand
 Plays with food
 Can use a straw
 May request certain foods
 Pulls on own simple garments
 Removes most of own clothing
 Verbalizes toilet needs

 Usually bowel trained with occasional accidents
 Usually urinates when taken to toilet
 Toilet trained in day time
 May still smear stool
 May brush teeth with help
 Attempts to wash self in tub or shower

 SENSORY
 Accommodation well developed
 Inserts square objects into its appropriate place or
hole
 May develop strabismus (squint)

 PSYCHOSOCIAL
 Sense: Has sense of autonomy
 Still egocentric in both thought and behavior
 Separation anxiety continues
 Shows early signs of individuality
 Independent from care giver
 Is possessive (mine not yours)
 Does want to share possessions
 May push other children as if they are objects out
of his way
 May want to make friends but doesn’t know how

 Pulls other persons to show them something
 Does not want to sleep so has many demands
before bed time
 Upset by changes in routine
 Thumb sucking decreased
 Focuses on own wishes
 Violent temper tantrums decreasing

 PSYCHOSEXUAL
 Anal stage

 INTELLECTUAL OR COGNITIVE
 Attention span is longer
 Memory increases
 Starts to understand past present and future
 Increased sense of time- can anticipate events
and can wait for them.
 Can pretend


 LANGUAGE
 Understands more complex sentences
 Can obey 2 commands given at the same time
 Enjoys stories with pictures
 No longer use jargon
 Knows about 300 words
 Refers to self by first name
 Uses pronouns I, me, mine
 Asks what’s, who’s that
 Tells about immediate experiences
 Identifies familiar objects
 Verbalizes need for drink, food and toileting
 May use the word now meaningfully
 About 66% of vocalization are intelligible

 PLAY AND STIMULATION
 Little social interaction with other children
 Begins to learn to replace toys in their proper place
 Frequently idle (dawdles)
 Pulls wagon
 Manipulates play materials such as clay, finger paints,
brush paints
 Sings songs
 Needs large puzzles and toys to take apart
 Enjoys hearing stories with pictures

 Takes favorite toys to bed
 Mimic domestic activities of parents
 Enjoys playing with dolls

 PHYSICAL
 Weight –gains about 5kg between 1 and 3 years
 Weight is quadrupled
 Height increases about 6-8 cm during the third
year
 Has a full set of 20 temporary teeth
 Daytime bowel and bladder control possibly
established

 MOTOR
 Can stand on one foot momentarily
 Walks on tiptoe for few steps upon request
 Walks up and down stairs one foot on a step
alternating feet
 Jumps well in place with both feet off the floor
 Jumps fro step or low chair
 Can throw a large ball 4-5 feet
 Can ride a walker or pedal car

 Builds a tower of 8 cubes
 Adds chimney to train or cubes
 Imitates circular strokes
 Holds crayon with fingers instead of entire hand
 Good hand-finger coordination
 SELF CARE
 Can feed himself with occasional spilling
 Pours from a jug often spilling
 Gets a drink without assistance

 Distinguishes between finger and spoon food
 Chews with mouth closed
 DRESSING
 Puts arm through large arm hole
 Buttons a large front button
 Unbuttons large front buttons
 Helps to put things away

 TOILET AND GROOMING
 Mastery of daytime bowel and bladder control
 May go to the toilet himself

 Control bowel at 26 months
 -Controls urination 30 months
 Needs assistance with wiping
 Attempts to wash hands adequately
 Can partially dry hands upon reminder

 SENSORY
 Recalls visual images

 PSYCHOSOCIAL
 Sense of autonomy (1-3 years)
 Theoretically autonomy is achieved at the end of
toddler period. If it is not achieved a sense of
shame and doubt predominates
 Still egocentric
 Learns to cope with separation anxiety
 Independent behavior increases
 Achieves some self control based on self esteem
rather than fear

 Reluctant to go to bed
 Negativism and dawdling continue
 Temper tantrums may or may not decrease
 Imitates sex role behavior of adults
 Knows own sex

 PSYCHOSEXUAL
 Anal stage (1-3 years)

 INTELLECTUAL
 Concept of time still limited
 Begins causal thinking
 Problem solving through trial and error

 LANGUAGE
 Identifies five body parts when named
 Gives full name (first and last) if asked
 Uses appropriate pronoun when referring to self “I”
 Uses plurals and past tense of verbs
 Talks constantly

 Asks why
 Uses 4-5 word sentences
 About 75 % of vocalizations are intelligible

 PLAY STIMULATION
 Helps to put things away
 Pretends in play

 Motor play
 Pushes and steers toys well

 Needs
 Large cars
 Trucks
 Cardboard boxes
 Block trains that interlock
 Carries breakable objects

 CREATIVE PLAY
 They need:
 Clay
 Finger paints
 Large crayons
 Large wooden puzzles
 Sand box toys
 String to string beads or lace large shoes
 Bright colored construction
 Paper to fold or cut with blunt scissors

 Quiet play
 Cloth or cardboard books
 Toys for water play
 DRAMATIC PLAY
 Baby doll and doll equipment
 Toys for house keeping such as small broom and dust cloth
 Play telephone

 The toddler’s curiosity may lead the child into danger for
example:
 Motor vehicle accidents
 Bath tub drowning
 Hot fluid scalding

 Electric shock leading to death
 Poisonous substances can kill the toddler
 Drugs can also kill or overdose
 Kerosene can kill
 Try as much as possible that all these are out of
reach of children

 The basic needs of a toddler are:
 Love and security
 Discipline leading to self control
 Progression to independence
 Achievement of control of bodily functions
 Nutrition
 Accident prevention

 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 since
the child feels loved and secure, the
frustrations everyone endures in the process of
maturation can be handled

 Both boys and girls give their first love to their primary
caregiver usually the mother, when the father gives the
same care as the mother the toddler generally feels
attached to and secure with both parents
 Toddlers may develop separation anxiety if the
primary caregiver leaves them alone for example in a
nursery school or hospital
 This is evidenced by:
 Restlessness
 Hyperactivity
 Depression manifested by crying and withdrawal

 Regression to earlier modes of behavior
 (Regression is returning to an earlier or former
state or type of behavior)
 The parents should understand that such
behaviors are normal
 Toddlers who are attempting to achieve autonomy
may become overwhelmed by separation anxiety
when the parents attention is diverted from them
to a new sibling or when they enter nursery school
or are admitted to a hospital thus they regress

 They may return to earlier behaviors such as
demanding to drink from a nursery bottle,
refusing to cooperate in toilet training and
loosing the various skills that they tried so hard
to achieve
 The best way to handle a child’s regression is
simply to ignore it.

 Discipline leading to self control
 Proverbs 22:6
 “Teach a child to choose the right path and when he is older
he will remain upon it.”
 Discipline means establishing and adhering to standards of
behavior for the toddler with the goal of self control

 It includes
 Setting of limits (rules and guidelines)
 These must be set on the daily behavior of children if they
feel secure

 Reinforcement of approved behavior by deepening this trusting
bond between parents and child is preferred over material
rewards.
 Constructive discipline helps the child to better behaved and
happier

 Qualities of constructive discipline
 Consistency
 Clarity
 Firmness- parents must mean what they say and say what they
mean
 Immediacy
 Encouragement of independence

 Disciplinary action
 A loving reward is more consistently effective
in disciplining a child than punitive actions
BUT:
 Punishment is a useful tool if used with
discretion
 Punishment should be given privately and
with respect

 Examples of punishment
 Physical punishment
 Explaining or reprimanding
 Disregarding or ignoring- This should be avoided if there is
danger of physical harm to the child
 Taking time out- this means that the child is removed from
any positive reinforcement when misbehavior occurs

 Instead of the parents giving a scolding or spanking for
unwanted behavior the child is placed in a boring situation
for a specified period of time. No playing is permitted
 This will be perceived as a punishment

 The toddler ultimately gives up the misbehavior in order to return
to the family group

 Outcomes of discipline
 Parents must define reality for their children and through
guidance and discipline, help them in their striving for maturity

 Types of parents who fail in this period
 Those that are over demanding and insist upon perfection in
behavior
 This causes intense anxiety and guilt in their children
 Those who set no limits or over permissive
 These fail to provide security and help to their children to learn to
live harmoniously in society

 Those who provide inconsistent discipline
 These make their children to find difficulties to develop
stable behavioral control and values
 Among the procedures for discipline the safest is the use of
time out or isolation
 Disciplinary action may sometimes be necessary but
remember children still need compassion, understanding
and respect for their developing independence

 DEPENDENCE PROGRESSING TO INDEPENDENCE IN
SELF CARE
 By the time children reach 3 years of age they are beginning
their journey to independence in self care

 Children learn to care for themselves initially
by attempting to imitate the actions of their
parents and siblings
 The achievements in self care includes
 Feeding
 Dressing
 Toilet
 Grooming

 ACHIEVING CONTROL OF BODILY FUNCTIONS
 Achieving control of 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 nappies 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

 Process of toilet training
 The parents record the times the child eliminates for
several days
 This record provides the toddlers own schedule for
training that is when it is appropriate to place the child
on a comfortable child sized toilet sit or potty chair
 The potty chair should be used only in the toilet room
or bathroom so that the act of excretion is associated
with this one location
 The parents take the child to the bathroom and calmly
explain in simple language what is to be done.

 Specific words that are widely understood to
indicate the acts of defecation and urination are
used
 The parents stay with the toddler during the entire
process.
 Do not allow the child to play at this time
 The accidents that occur during the process of
toilet training should be ignored
 A two year old toddler is generally toilet trained in
the day time

 The 21/2 years old may have begun to master night
time bladder control however accidents are common
 Night time bladder control may not be complete until
the child is 4-5 years of age

 Fecal smearing
 This behavior occur between the ages 15-18 months
 The desire to smear may be sublimated by providing
clay, damp sand and mud

 Therefore avoid shaming and ridicule
 A young child who is categorized as being
“good” or “bad” usually lives up to the
appropriate expectation.
 The child’s own effort also promotes or reduces
self esteem
 Patience and persistence are necessary in
helping children develop self esteem as they
become able to cope with life in their world

 PLAY AND STIMULATION
 Functions of play:
 Play during the toddler period stimulates all areas of
growth and development
 The social importance of play increases as the child
grows
 Active play encourages gross and fine muscle
development-surplus energy is worked off
 When playing besides and watching others they seem
to want to be friendly but at this time their social skills
are inadequate so adult supervision is necessary

 Play assist the toddler to fully develop the concept of object
permanence
 They develop very early understanding of moral values
 They learn differentiate between right and wrong when they
are taught not to hurt others in play
 They develop language and speech when they talk to toys,
pets, others parents

 Reading and singing to child helps
 Negative feelings and tensions can be released in an
approved way for example an angry child can find relief by
pounding soft balls or begs through holes in a board or
tossing bean bags

 PLAY RESPONSES
 In early toddler period play is free and
spontaneous
 They are in most cases destructive
 They normally claim their own toys by saying
“mine, mine”
 They learn sharing later
 Do not encourage them to give up their toy until
later on.

 PLAY RESPONSES
 In early toddler period play is free and spontaneous
 They are in most cases destructive
 They normally claim their own toys by saying “mine, mine”
 They learn sharing later
 Do not encourage them to give up their toy until later on.

 NUTRITION
 Nutritional intake include the essential nutrients in the
amount necessary for maintenance, replacement and growth
of tissue and for energy

 They are usually 3 well spaced small meals with in
between nutritious snacks each day.
 Toddlers need less food per unit of body weight during
the second year of life than infants because the growth
rate is less rapid.
 At about 18 months toddlers develop what is known as
physiological anorexia
 If inadequate amounts of vitamins and minerals
especially iron are not obtained in the diet because of
the anorexia supplements can be prescribed
 Children may prefer playing than eating, so take care
of the meal times

 ACCIDENT PREVENTION
 Accidents are the largest single cause of mortality and
disability between the ages of 1-4 years
 Accidents include
 Motor vehicle accidents
 Drowning
 Burns
 Suffocation
 Falls
 Poisoning
 Other injuries e.g. cuts

 When parents understand their child’s level of
growth and development they can predict the
hazardous situations that may result in an
accident then judge how much responsibility
the child can assume for self protection
 If the child is injured accidentally point to the
child the cause of the accident and it will be a
lesson to the child.

Average achievements of a toddler 18 months

Recommended

Recommended

More Related Content

Viewers also liked

Viewers also liked (6)

Similar to Average achievements of a toddler 18 months

Similar to Average achievements of a toddler 18 months (20)

Recently uploaded

Recently uploaded (20)

Average achievements of a toddler 18 months