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Chapter: 11th 12th std standard Class Nursing Health Care Hospital Hygiene Higher secondary school College Notes

Growth and development of a Toddler

Toddlers, gradually, gain physiological maturity and become more capable to fight infections, maintain body temperature, and carry other physiologic functions (Wong, 1993).

Growth and development of a Toddler:


1. One to three years:


Toddlers, gradually, gain physiological maturity and become more capable to fight infections, maintain body temperature, and carry other physiologic functions (Wong, 1993).


Physical changes. Toddlers appear tall and leaner because their chest circumference exceeds the abdominal circumference. They retain their pot Belly with short legs that are slightly bowed. During the toddlerhood, child gains about 2 to 3 kg. of weight per year.

The birth weight quadruples by 30 months of age, The height increases by 7.5 cm. per year. Two- year- old is about 85 cm. Tall and three years old is about 93 cm. The head circumference becomes equal to 'chest circumference by the two years of age. Anteroior fontanal closes by 12 to 18 months of age.


1.A Sensory Development:


During the toddlerhood, full binocular vision is well developed. Development of depth perception continues. Sense of hearing, smell, taste, and touch are well developed. All these senses are used to explore the environment and objects. Toddlers may lack the muscle coordination and is at risk of fall from the height.


1.B. Motor Development


Gradually, the toddlers develop control over the muscle and develop fine motor skills. By 12 to 15 months, they can walk without support. By the 18 months, they learn to run. By two years, they can run well with a wide stance, and can walk up and down stairs. By 2 ½years, they can jump.


Fine motor skills are developed with the pincer grasp by 9 moths to 10 months, so they seem to grasp very small objects. By 15 months, they repeat voluntarily throwing objects. By 15 months, they can place the round object in the hole.


By two years, they can build a tower of six to seven blocks and by 30 months, a tower of eight or more blocks. By 15 months, they can scribble spontaneously. By two years, they can imitate a circular stroke and a vertical line. Motor skill development is observed in toddlers' play, dressing, language development, response to discipline, social interactions, and exploratory activities.


Physiologic functions are matured, by the age of three years. Stomach capacity is increased and toddlers can have three meals a day. By 14 to 18 months, toddlers can retain urine for two hours.


1.C Psycho-social development:


According to Erikson (1968), when toddlers try to develop autonomy, during the process of autonomy, they overcome a sense of doubt and shame. To hold on and let go technique is found during use of hands, mouth, eyes, and sphincter.


Toddlers can express emotion very strongly. They use 'no' in their vocabulary. Swift change is seen in toddlers' mood. They may get angry if they are unable to manipulate an activity. A temper tantrum is common. Sudden changes in their behaviour are difficult for the parents to understand and manage with.

Parents may give into toddlers' negativism, instead of handling it constructively. Toddlers like sameness, ritualism, which provides them with the sense of reliability and comfort. They prefer familial places, people, and routines.


1. D Cognitive Development:


Toddlers can think and try to find the reason for actions. They use trial-and-error method to explore and get results. They learn to develop language. They learn to imitate with the intellectual ability. Identification with .the parent of same sex occurs by two years of age. They have a limited attention span.


Toddlers, gradually, learn the names and uses of the respective body parts. They use their own symbols to describe an object. Toddlers have unclear body boundaries and may associate nonviable parts with the body parts. Toddlers should be taught to respect the body parts by their proper names. They also find that touching certain body parts is pleasurable. Parents should accept the toddlers' sensual activities.

Following areas need specific attention and guidance:


1.     Control over bodily functions of urination and defecation.


2.     Communication and language.


3.     Learning social norms.


Toilet Training:



Controls over defaecation and urination are two personal phases of toddlers' learning, closely related to their sensory and motor control. They should be taught to excrete urine and faeces at the appropriate time and place, only when they are ready.

Toddlers achieve voluntary control of the anal and urethral_sphinctcr between the age, of 18 and 24 months. Toddlers can recognize the, urge to hold and let go by the age of two years.

Toddlers become aware of pleasing their parents by holding on. Parents must recognize the children's physical and psychological readiness for the toilet training. The training for toilet can be started around the age of 18 months. The daytime bladder control develops by the age of two years.

Night bladder control should not be hurried. The toilet training should not be started during illness. The selection of the potty chair is important-to fit the child's position and supports the child's feet while sitting on the potty.


Parents should have confidence in toddlers' ability to learn and must give reasonable time. The practice may be limited to 5 to 10 minutes. The parents should not force the child to sit on the potty or spank him / her for haying accidents. It is the child's cooperation, which is important for the successful learning experience.

If the mother shows a disgust about the process of excretion and gets annoyed, the toddlers will feel ashamed of their body and may feel that they are not lovable. If they have not developed a trust in their mother, they may not be strongly motivated.


1.E Language development:


Toddlers are able to understand others and express their feelings and ideas in words. They may continue to express through their gestures. They understand the meaning of the word. The mothers' voice, tone, and gestures help them to understand the meaning of the words. To speak, toddlers must have a satisfying relationship with their mother.

When they think, the mother responds to their words, they are motivated to speak. They speak to express their; needs. If their needs are supplied without their asking, they may. not be motivated to speak. In the beginning, they get pleasure in talking. They talk to anyone, example, to the people, pets, toys, and to themselves.


1.F Vocabulary building:


First, toddlers learn the nouns of one syllable, such as, Ma-Ma, Ba.-Ba., Pa-Pa. Next they learn verbs that mean some form of action which he sees, such as, give, take, rim.


By two years, gradually, they learn adjectives and adverbs. 6y three years, toddlers know about 900 words. Their ability to understand the words is greater than actually saying the words. Toddlers can speak one word sentence at the age of one year and can speak, (two to three word sentences by the age of two. Gradually, the sentence formation and expressing with the gesture are developed.


1.G Delayed Speech:


If toddlers do not speak by the age of two years, the cause of the delayed speech may be investigated.


I. H Social development:


Toddlers develop independence that is evident in their determined, strong -willed, volatile behaviour. They swiftly become docile and lovable to please their parents. They enjoy developing skills in carrying out daily activities such as feeding, dressing, playing, and developing control.


By 15 months, they can feed themselves and drink from a cup. By three years, they can eat with the family. By 15 months, toddlers try to remove their dress or shoes by pulling. By two years, they can put on their shoes and pants.


Play provides the opportunities for toddlers* physical and psychological development. Toddlers talk with the toy and try to use their senses to explore the characteristics. Parents should protect the child from the risk of injury when me child manipulates the toys.

Toddlers become social, with the development of ability to use the language and social behaviour. Play activity provides the toddler with opportunities to team and develop socially acceptable behavior.


They team differentiation of self from significant others. Differentiation includes the process of separation, from the significant others, and individualisation, which is developed by the achievement of individual identity in the environment. Toddlers seek security. The object which provides sense of security becomes important to them.


1.I Limit-Setting:


Setting limits and shaping the toddlers' behavior is an important task. Parents may find it difficult to set the limits as toddlers are changing their activity with increased mobility and increased exploration and manipulation of the environment. While setting limits, reasoning does not work for the toddlers because they are egocentric. Setting simple rules and applying them consistently help to limit their behaviours.


1.J Dental Health:


Oral hygiene should be started from the neonatal period. Cleaning of the gums with the moist cotton is important. Parents should be encouraged to clean the teeth of their infants as soon as they erupt. A small children's toothbrush with soft, rounded, multi-tufted nylon bristles that; are short and uniform in length is recommended.


For toddlers, effective brushing can be done by parents. The toddlers can participate in brushing. The toddlers should see a dentist, at least by the time when primary dentition is completed. Oral and dental hygiene is important in toddlers as they are prone to develop baby bottle tooth decay (BBTD).


2. From 12 to 18 months:


Toddlers stand and walk without a support and creep-upstairs. They explore drawers, open boxes and pokefingers in holes. By 18 months, their anterior fontanelle is closed.


3. From 18 to 24 months:


Toddlers can run well and walk up and down with two feet per step. They can kick a large ball. They can imitate strokes with a pencil.

4. From 2 years to 3 years:


During this period, toddlers can hop on one foot. They can ride a tricycle. They can feed themselves.


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11th 12th std standard Class Nursing Health Care Hospital Hygiene Higher secondary school College Notes : Growth and development of a Toddler |

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