The document provides an overview of toddler development between the ages of 1 to 3 years, detailing growth patterns, motor and language development, emotional and social milestones, and the importance of nutrition and safety. It emphasizes the role of parents in supporting their child's autonomy, managing common challenges such as negativism and separation anxiety, and implementing effective discipline strategies. Additionally, it highlights health promotion through regular check-ups and safety practices to prevent accidents and lead poisoning.

1. Toddler Development

2. Toddler period
• It is between 1 to 3 years of age.
• During this period, growth is considerably slow.
• Children in this age have a growing sense of autonomy (independence).
• Parents must also grow during this period. The parent’s task is supporting
their child's growing independence with patience and sensitivity.

3. Physical Growth
(1) Weight
• Average weight gain is 1.8 to 2.7kg/year.
• Formula to calculate normal weight of children over 1 year of age =
Age in years x 2 + 8 = -------Kg.
(2) Height
• Height is calculated for children from 1-5 years of age by the equation:
(Age in years x 5 + 80)= ………… Cm.

4. Physical Growth
(3) Head Circumference
• By 2 years, chest circumference has grown greater than that of the head.
(4) Body contour:
• Toddlers tend to have a prominent abdomen, because although they are
walking well, their abdominal muscles are not yet strong enough to support
abdominal contents as well as they will later.
• Toddlers have a forward curve of the spine at the sacral area (lordosis). As
they walk longer, this will correct itself naturally.

5. Body systems
Body systems continue to
mature during this time
• Respirations slow slightly but continue to be
mainly abdominal.
• Stomach secretions become more acid; therefore,
gastrointestinal infections also become less
common.
• Stomach capacity increases to the point a child can
eat three meals a day.
• Control of the urinary and anal sphincters by 24-
30 month.
• Teething: By 2 years primary dentition of 16 teeth.
• 20 teeth by 30 months.

6. Motor Development
• AT 15th
months
- Walks alone without help.
- Creeps upstairs.
• At 18th months
- Walks backward and sideways.
- Jumps in place with both feet.
• At 24th months
- Runs well.
- Goes up and down stairs alone with two feet with each step.
• At 30th months
- Stands on one foot alone.
- Walks up and down stairs, one foot on a step.

7. Language Development
Toddlerhood is a critical
time for language
development, because
children need a practice
time.
A child who is 2 years
old should talk two-
word & simple
sentences.
The toddler learn
language from
imitating what
they hear.
A word that is used
frequently by toddlers is
“No” which reflect their
autonomy
development.
Toddlers use “NO” when:
• they are refusing a task.
• they do not understand it.
• they practice a sound that they
have noticed has patent effects
on those around them.

8. Language
Development
• Language develops most quickly if
parents:
1) Respect what toddlers have to say.
2) Make conversation with toddler.
3) Answering their questions (simple and
brief).
4) When they give their toddler something,
they must name it.

9. Social
Development
Autonomy:
The developmental task of the toddler years a
is the development of a sense of autonomy
versus shame or doubt.
 They start to do what they want because they
want that & they can do it.
They are very difficult to manage.

10. Emotional
Development
The toddler is;
- Less fear of strangers.
- Develops separation anxiety.
- Temper – tantrums of anger expression.
- Afraid from falling and loud voices.

11. Play behavior
All during the toddler period, children play
beside the children, not with them. This
Side-by-Side play (called parallel play).
Caution parents that if two toddlers are
going to play side by side, they must provide
duplicate toys or an argument over one toy
is likely to occur.
 The toddlers enjoy toys that require action
(dolls that can be squeezed, pulled).

12. Toddler Needs
1-Nutritional requirements
-Caloric - protein - milk requirements.
2-Rest and sleep
-Average 12h daily.
3-Dental health
-Clean teeth with soft toothbrush.
-Fluoride supplementation.
-Diet should be low in sugar.
4-Love and security
-Avoid separation anxiety.
5-Toilets training

13. Health promotion for toddlers
Toddlers tend to develop many upper respiratory and ear infections, so family is always
recommended to have a schedule visits to check up their children.
This scheduled visits provides an opportunity for health promotion & early detection of any
growth and development delays.
Promoting Toddler Safety:
Accidents are the major cause of death in children of all ages.
Accidental ingestions (poisoning) are the type of accident that occurs most frequently in
toddlers (medication & cleaning products).
Other accidents that occur frequently in toddlers include motor vehicle accidents, burns,
falls, and playground injuries.

14. Activities to ensure toddler safety
1) Supervising
child closely
when in public
settings.
2) Educating child
about dangers of
throwing, hitting.
3) Preventing
access to
electrical outlets,
cords.
4) Securing gates
and doors.
5) Maintaining
water heater
temperature at
120° to 130°F.
6) Using car seat.
7) Instructing
child on street
dangers.
8) Storing all
lighters, chemicals,
cleaners, and
personal care
products out of
child's reach.
9) Ensuring
multiple barriers
to pools and hot
tubs.
10) Instructing child
on dangers of
weapons and fires,
and also how to get
help when feeling
scared or in danger.
11) Selecting toys
carefully.
12) Instructing
child about
stranger danger
and good
touch/bad touch.

15. Lead Screening
All children between the ages of 6 months and 6 years should be tested
periodically for the presence of too much lead in their body (lead
poisoning).
Elevated lead levels are caused by eating, chewing, or sucking on objects (such
as windowsills, paint chips, or furniture) that are covered with lead-based paint.
Or Colored print in newspapers; old water pipes.
lead is toxic to body tissue, ingestion of it can lead to serious damage to the
brain and nervous system, kidneys, and red blood cells.
Levels as low as 10 to 15 μg/dL can cause learning and behavioral problems.
High levels may result in seizures, cognitive challenges, coma, and even death.
Beginning symptoms of lead poisoning include irritability, headache, fatigue,
and abdominal pain.

16. Promoting Nutritional Health of a Toddler
Teaching parents about nutrition of toddler's
nutrition because toddler's appetite becomes
lesser than the infant
• Discontinuation of bottle feeding
• Offering small portions and frequent feedings
• Continued use of spoon and self - feeding
• Avoidance of force feeding
• Use of healthy snacks
• Limitation of fluids before meals
• Regularity of mealtimes
• Healthy food choices for the child, including
raw and cooked vegetables
• Creative food preparation for the
picky eater
• Limitation of fat content in foods
• Avoidance of high-sugar cereals
• Child participation in food
preparation
• Avoidance of food as a reward

17. Promoting Toddler Development in Daily Activities
Dressing
Toddler try to dress themselves but most of time in wrong way.
So instruct parents to give up from perfection in order to enforce the child’s
sense of autonomy.
Sleep
In the beginning of toddlerhood period, toddler have two naps a day and sleeps
12 hours each night.
And end it with one nap a day and only 8 hours' sleep at night
Bathing: It is not restricted for a time or a routine, only when needed.
Care of Teeth: They can begin to do the brushing themselves under supervision. Urge parents to
schedule a first visit to a dentist skilled in pediatric dental care by 2.5 years of age for assessment of
dentition.

18. Parental Concerns Associated with the Toddler Period
Negativism
Separation
anxiety
Toilet
Training
Ritualistic
Behavior
Temper
tantrums
Discipline

19. Toilet training
Toilet training is
one of the biggest
tasks a toddler must
achieved.
Most first-time parents
ask when to start, when
training should be
completed, and how to
go about it.
The answer is that toilet training
is an individualized task for
each child. It should begin and
be completed according to a
child's ability to accomplish it,
not according to a set schedule.
Before children can begin to
be toilet trained, they must
have reached three important
developmental levels, one
physiologic and the other
two cognitive:
1. They must have
control of rectal and
urethral sphincters,
usually achieved at
the time they walk
well.
2. They must have a cognitive
understanding of what it means
to hold urine and stools until
they can release them at a
certain place and time.
3. They must have a
desire to delay immediate
gratification for a more
socially accepted action.

20. Negativism
As part of establishing their identities as
separate individuals, toddlers typically go
through a period of extreme negativism.
• They do not want to do anything a parent wants
them to do.
• Their reply to every request is a very definite “no.”
• Parent need some help to realize this is not only a
normal phenomenon of Toddlerhood but also a
positive stage in development.
• This change indicates their toddler has learned he
or she is a separate individual with separate needs.

21. Separation anxiety
Fear of being separated from parents begins at about
6 months of age and persists throughout the preschool
period.
This universal fear of this age group is known as
separation anxiety. For this reason, toddlers have
difficulty accepting being separated from their
primary caregiver.

22. Ritualistic Behavior
Although toddlers spend a great deal of time
every day investigating new ways to do things
and doing things they have never done before,
they also enjoy ritualistic patterns.
They will use only “their” spoon at mealtime,
only “their” washcloth at bath time. They will
not go outside unless mother or father locates
their favorite place.

23. Temper tantrums
Almost every toddler has a temper tantrum at one
time or another. The child may kick, scream, stamp
feet, shout, “No, no, no,” lie on the floor, flail arms
and legs, and bang the head against the floor.
Children may even hold their breath until they
become cyanotic and fall to the floor.
This is harmless breath holding, ignoring it will
make it ineffective and the child will give it up.

24. Temper tantrums
True breath holding is a neurologic problem in which a child, under stress, appears to “forget” to breathe
or halts breathing after expiration, usually at the peak of anger.
Temper tantrums occur as a natural consequence of toddlers' development.
For example, temper tantrums occur most often when children are tired, just before
naptime or bedtime, or during a long shopping trip or visit. The tantrums may be a
response to an unrealistic request by a parent: asking a child to comb his hair before he is
coordinated enough to do so, asking her to pick up her toys before she has a feeling of
family responsibility.
Also, they may
occur if
parents are
saying “no”
too frequently.

25. Discipline
Punishment: is a consequence that results from a breakdown in discipline,
from the child's disregard of the rules that were learned.
Discipline: means setting rules or road signs so children
know what is expected of them.
Remind parents that “discipline” and “punishment” are
not interchangeable terms.
Some parents ask during the last part of the infant year or the early
toddler period when they should start to discipline their child, or when
toddlers are old enough it is all right to punish them.

26. Discipline
Parents should begin to instill some sense of discipline early in life
because part of it involves setting safety limits and protecting others
for example, the child must stay away from the fireplace or heater ;
she must not go into the street; she must not hit other children.
correct behavior is praised rather than wrong behavior punished.
“Timeout” is a technique of helping children learn that actions have
consequences. To use “ timeout” effectively, parents first need to be certain
their child understands the rule they are trying to enforce: for instance, “If
you hit your brother, you'll have timeout."

27. Thank you