● Discuss counseling efforts for parents dealing with toilet training, masturbation, feeding, and
medication administration in young children less than 6 years of age.
○ Toilet training:
■ Toddler age: 1-3 years.
● Sphincter control begins around 2 years.
● Child’s bladder, bowel muscles, and innervations must be physically
mature and the bladder large enough to hold urine for several hours at a
time.
● Child should be able to remove pants and underwear independently, sit
quietly for short periods, imitate behaviors, and want to please parents.
● Success should be praised and accidents cleaned up without comment.
● If child is not interested, it is best to stop and wait a month.
○ Masturbation:
■ Preschool age:
● Occasional masturbation is normal and an expression of sexual
development.
○ Feeding: *one of the major activities for infancy
■ Infancy age:
● Food introduction:
○ Breast milk/iron fortified formula for 1st year
○ Grains: 4-6 months
○ Fruits/vegetables
○ Meat/eggs
● Instructions:
○ Feed all solids with spoon
○ Introduce at 3-4 day intervals
○ Eczema is a common reaction
○ Do not dilute formula
■ Toddler age:
● Growth slows at age 12-18 months, the appetite and need for food
decreases.
● Toddlers are picky and ritualistic eaters.
● Avoid large pieces of food such as hot dogs, grapes, cherries, and peanuts.
● Be aware of food temperature.
● Child is able to feed self by 3 years.
■ Preschool age: 3-6 years
, ● Similar to toddler’s eating patterns.
● Demonstrates food preferences: likes and dislikes
● Influenced by others’ eating habits
● Requirement is of 90 kcal/kg/day
○ Medication administration:
■ Preschool age: 3-6 years
● Body mutilation - explain procedures in simple terms, offer band-aids,
give examples of sensations
● Define growth and development. - pg. 746
○ Growth - refers to an increase in physical size.
■ Represents quantitative changes such as height, weight, blood pressure, and
number of words in a child’s vocabulary.
○ Development - refers to a qualitative increase in capability or function.
■ Developmental skills, such as the ability to sit without support or to throw a ball
over hands, unfold in a complex manner influenced by the relationship between
the child’s innate capabilities and the stimuli provided in the environment.
● What are two of the major development principles?
○ Cephalocaudal - proceeds from the head downward through the body and toward the
feet.
■ Ex: at birth an infant’s head is much larger proportionately than the trunk or
extremities. Infants learn to hold their head up before sitting and to sit before
standing.
○ Proximodistal - motor skills. proceeds from the center of the body toward the extremities.
■ Ex: infants are first able to control the trunk, then the arms; only later are fine
motor movements of the fingers possible.
● Discuss how to approach children for assessments, and what are the major assessment
parameters in the first years of life?
○ Example from lecture: might have to take everyone’s vital signs before child’s
○ Major assessment parameters - pg. 755, table 31-5
■ Activity level - degree of motion during eating, playing, sleeping, bathing.
■ Rhythmicity - regularity of schedule maintained for sleep, hunger, elimination.
■ Approach or withdrawal - response to a new stimulus such as food, activity, or
person
■ Adaptability - degree of adaptation to new situations.
, ■ Threshold of responsiveness - intensity of stimulation needed to elicit a response
to sensory input, objects in the environment, or people.
■ Intensity of action - degree of response to situations
■ Quality of mood - predominant mood during daily activity and in response to
stimuli
■ Distractibility - ability of environmental stimuli to interfere with the child’s
activity
■ Attention span and persistence - amount of time devoted to activities (compared
with other children of the same age) and the degree of ability to stick with an
activity in spite of obstacles.
● Discuss weight to height percentiles and what it means to be 25%, 50%, and 75% on the
height/weight chart.
○
((((( 25% - the baby is less than average amongst others in his weight/height group
50% - the baby is average amongst others in his weight/height group.
75% - the baby is above average amongst others in his weight/height group. )))))
● Discuss how to assess for gross motor and fine motor movements in children.
○ Gross motor:
○ Fine motor:
((((((((((((((((((((((((
Age Fine Motor Gross Motor
Birth - 1 mo Holds hand in fist Reflexes as startle and
Draws arms and legs to rooting
body when crying Lift head briefly if prone
Alerts to high-pitched voice
Comforts with touch
2-4 mo Holds rattle Moro reflex fading
Looks at and plays with Can move side to back
own fingers Decrease in head lag when
Brings hands midline pulled to sitting position.
When prone, holds and
supports weight on
forearms.
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