Erikson/Piaget/Freud/Kohlberh
Meet physiologic and safety needs (Maslow), meet needs and pay attention to baby/crying, not neglecting or ignoring cries, being attentive
most important indicator for health in children!
growth! = physical maturation and size of child
development = process of acquiring skills and functions
what 2 immunizations should NOT be given to an immunocompromised/sick child?
rotavirus and flumist flu vaccine because they are LIVE vaccines and not inactivated, which could induce sickness in the immunocompromised child
rotavirus: rotarix at 2/4 mo or rotateq at 2,4,6 mo
flumist: 6 mo, 2 doses 1 month apart then annually
describe at least 3 parts of effective discipline for a late age toddler/preschooler
what is not considered effective?
effective: structured environment, rules and limit setting, use of if-then instruction to acknowledge consequences, CONSISTENCY, time out 1 min for each yr of life
not effective: corporal punishment, yelling, anger, physical punishment because it fosters fear, distrust, low self-esteem, and injury in child (shame/doubt and guilt in terms of Erikson)
#1 cause of death for children 1-19 is?
unintentional injuries
- MV!!!!
- firearms
- drugs
a 5 year old does something that would be perceived as naughty or not nice, which results in the child feeling bad. Which Erikson and Kohlberg phase is this demonstrating?
Erikson: initiative vs. guilt
Kohlberg: pre-conventional stage
advantages of breastfeeding vs bottle feeding?
in what situation would you suggest bottle feeding OVER breastfeeding?
advantages: easy digestion, immunity from mom (IgG), promotes myelination and bonding (oxytocin)
would not recommend with mothers who are HIV positive, use drugs (illicit or chemotherapy), active TB, galactosemia (where body cannot produce galactose sugars)
a 6 month old can sit with support, swallow drool up, and no longer sticks their tongue out frequently like they did in earlier months. What are they ready to start?
introducing solid foods (4-6 mo) after the tongue extrusion reflex is gone, they can swallow, they have digestive enzymes for fats and carbs (4-6mo devel), and can sit with support in the highchair
- 1st food is iron fortified rice cereal -> cereals, veg, fruit, meat
-pureed or mashed to avoid aspiration
- introduce every 3-5 days to id allergies
- sippy cup 6-8mo!
what is some anticipatory guidance you would the teach parents of a budding toddler?
car: keep in back seat, use proper toddler car seat, properly buckled with no twisting or loose seat belt
water: never leave alone near water or in bath, fence pool areas, swim lessons, floaties whenever around water
ingestion: less discriminating test increases risk of poisoning, keep meds away with childproof caps, keep detergent/soaps away, be careful with vitamins because of iron toxicity
falls/injury: toddlers are top heavy and have a pot belly that affects balance
etc: by 2 yrs toddler may learn how to turn knobs, keep doors locked, keep away from stove knbs etc
what emotional and social changes do adolescents go through that support Erikson's perceived goals of this age range?
BIG CHANGES, are egocentric and self-centered, question parents and family values, try to explore world on own, struggle with body image, explore sexuality, shift of reliance on PEERS rather than solely on parents, test boundaries and rules, interpret laws/society/instilled traditions in new ways
these all support the goal of achieving IDENTITY and sense of self
describe the conventional stage of Kohlberg's moral development
extra points if you say the age range for stages
stage 3: 7-10 yrs or early school age
- follows rule to avoid punishment and be good, adults = authority
stage 4: 10-12 yr
- law and order, follow the golden rule!, acts judged on intention not punishment, actions done out of respect
name 3 of the primitive reflexes and when should they be gone?
moro (startle), rooting, suck, palmar, plantar, asymmetric tonic neck, Babinski
all but babinski should be gone within 3-9 mo (MUST BE GONE 9-12 mo)
Babinski should be gone by 1 yr (MUST BE GONE BY 2yr)
describe info about the 5 infant senses
smell: can differentiate smell of mother's milk by 7 d
sight: see 8-15 inch, 20/200+, can see light/dark/contrast/mvmt, eyes wander from 1-2 mo, color vision by 7mo
hearing: should be intact at birth (baer test)
taste: prefer sweet, undeveloped taste
tactile: respond to gentle touch, rough touch can affect Erikson's goal of trust v mistrust
what is the best way to go about the fears of a toddler vs a preschooler when they are hospitalized?
toddler: fear of pain!
- be prepared, be short and brief, pre-speak to family, have parent comfort child, go eve level, simple terms, support "its okay to cry"
preschooler: fear of bodily mutilation
- bandaids, dressings, casts, quickly covering injuries and dispelling fears
puberty causes adolescence to be the 2nd fastest growth period after infancy. What time do boys vs girls go through puberty and what changes happen?
bonus points: what is the name of the stages of 2ndary sexual characteristic development
girls: puberty/breast bud development starts around 9-10, menarche around 12 or 2 yrs after bud development, grow 2-8 in, gain 15-55 lbs
boys: starts 10-12 yr, spermarche 13-14 yr, grow 4-12 in, gain 15-65lbs
both start production of FSH, LH, stimulation of estrogen/progesterone, need more calcium, need more iron, need more protein, full ossification of bones (2yr after start), increase acne/oily/hair growth/sweat, body image issues
Tanner Stages
1. In the sensorimotor stage, how does learning happen?
2. which age group does this stage apply to?
3. give an overview of the stage and/or substages of this phase
1. through senses and motor skills, also known as circular learning
2. infants (28d to 1 yr)
3. start with reflexes, do an action accidentally and then for pleasure, repeat actions for wanted results but with no end goal, coordinating learned schemes with learned behaviors (anticipate events, object permanence, associate symbols with events)
what are the 3 major tasks of adolescence (not eriksons) and describe them
object permanence: knowing something is still there even when covered up or not in view, begins 8 mo, finalized by substage 4 of sensorimotor stage
stranger anxiety: protective mechanism, comes out of blue, NORMAL, happens by 8 mo when infant knows loved ones vs strangers, helps develop autonomous identity
separation anxiety: distraught over being away from caregiver, can go from around 8 mo to 2 1/2 yrs
describe the differences in weight, length, and head circumference of a newborn vs a 12 mo yr old
- newborn: average 7.5 lbs, lose 10% first week, regains in 10-14d
- 12 mo: triple birthwgt
length
- Newborn: average 20 in
- 12 mo: length increases by 50%, at least 30 in
HC
- newborn: average 14 in
- 12 mo: 4 in larger than birth (around 18 in)
what is some anticipatory guidance you can give the parents for a budding preschooler?
wheels: helmets and protective gear for all wheels, preschoolers can ride a tricycle at 3 yr and ride a bike with training wheels at 5 yr
water: never leave unattented near or in water, life preservers for boats, floaties always, swim lessons, PARENTS SHOULD LEARN CPR
home: teach about dangers of firearms, must lock up firearms and separate ammo, teach dangers of second hand smoke, keep meds/dangerous ingestables locked away
physical safety: teach about stranger danger, adults/anyone should not touch you where your bathing suit is
school age children foster a sense of worth through what and according to who?
through series of successes and exposure to activities through school (academics, music, clubs, sports, extracurriculars)
according to Erikson in terms of industry v inferiority
children are able to have successes because of their improved coordination, balance, rhythm, hand-eye coordination, and more due to myelination
give an overview of Piaget's cognitive phases
all 4!
preoperational: (toddler) symbolic thoughts, magical/thinking, animism, pretend play/imagination, (preschool) better concept of time, egocentric, thoughts powerful, transductive reasoning, imaginary friends concrete operational: see diff points of view, id consequences, classify and organize collections, understand conservationism, understand time by 8 formal operations: egocentric, abstract thought matures, sees all points of view, risky behaviors, feelings of invisibility
what are the important GROSS MOTOR milestones for months 3, 6, 8, and 12?
FINE MOTOR milestones for months 5, 7, 8, and 10?
3: head control, raises head 45 degrees in prone 6: tripod sits (sitting with support from hands). 8: sits unsupported 12: sit from standing and walks (should be walking by at least 18 mo)
FM: 5: grasps rattle intentionally 7: transfers objects from one hand to other hand 8: gross pincer grasp (rakes) 10: fine pincer grasp, puts objects into and out of container
what are the months/yrs associated with the acronyms DIPHR, Harry v Potter MD, and I Did My Vaccines?
bonus points if you can name the vaccines in the acronyms (the ones we talked about in class)
DIPHR = 2, 4, 6 mo
- Dtap, IPV, PCV, HIB, Rota
HvP MD = 12-15mo
- HIB, PCV, Dtap (15-18 mo)
IDMV = 4-6 yr
- IPV, Dtap (booster)
which correctly describes the speech of a 4-5 yr old preschooler?
1. vocab of 1000 words and speaks in 3-4 word sentences, uses telegraphic speech
2. uses 3-4 words that have meaning (dada, mama, baba, etc.)
3. speaks in sentences and has/utilizes metalinguistic awareness
4. speaks in sentences with a vocab of 2000 words
Correct answer is 4: speaks in sentences with a vocab of 2000 words
1. this is characteristic of a 3 yr old (late toddler/early preschooler)
2. this is characteristc of a 12 mo old
3. this is characteristic of a school aged child
1. What can these feelings lead to?
2. What is some anticipatory guidance you can think of to help with this?
1. wanting to stand out or fit in, risky behaviors, peer pressure, experimentation with alcohol/drugs, experimentation with risky sexual behaviors and dating (STIs, pregnancy), possibly depression or suicide (big COD for 10-24 yr olds)
2. primary prevention education, parental and academic support, have appropriate consequences and discipline, positive reinforcement, allowing teen to negotiate and collaborate w/in reason when it comes to discipline