Study guide
NR 602 D&M 3 NDNP 864 Midterm Study Guide
Midterm Study Guide

Week 1: Early child development notes (chapter 6):

Toddler: 12-24 months 
Preschoolers: 2-5 years old 

WHO growth charts should be used to measure weight and length for children less than 24 months
CDC weight and length charts used for children older than 24 months 

Average 24 month weighs 26 lbs, length 33.5 in and HC 18.5 in 
Most have no palpable fontanelle by 12 months 
Ant fontanelle closes by 18-19 months
3-6 yrs weight gain expectation is 4.5-6.5 lbs/year
3-6 yrs height gain expectation is 2.5-3.5 inches/yr
4 yrs length at birth has doubled
4-5 years old legs grow faster than rest of the body 

Use of dominant hand may appear as early as 8-12 months generally emerges 2-4 years old; handedness established at 5yrs

May develop bowel and bladder control by age 3, but many will not. Boys usually take longer than girls to maintain bedtime bladder control. 

Articulation:
-24 months- 25% is understood by a stranger 
-24m-36m- 66% is understood by a stranger 
-3 years old- 90% should be understood by a stranger 
3 and 4-year-old have a normal hesitance or show stuttering, considered abnormal if beyond 5 years of age 

Speech problems often can be from lack of stimulation, hearing problems, ear infections, developmental delay. Early detection important. 

Lexicon:
girls typically say their first word between 8-11 months; boys by 14 months 

2 year olds: have more than 200 words in their vocabulary 
3 years old: 900 words in vocabulary
3-4 yrs old: able to follow simple commands, talks incessantly
4-5 year olds: add at least 50 new words a month; 1500-2100 words in vocabulary (including names, coins, colors, knows days of the week) 
5 year olds: should be able to define certain words with other words (cup: something you drink with)

Syntax:
8 months: develop receptive language- they understand what a word means before they are able to use it themselves 
12-28 months: use holophrases (single words) to express whole ideas 
18 months: use telegraphic speech (get milk, go bye-bye)
2 years old: short sentences
3 years old: add plurals, 3-4 word sentences
4 years old: past tense
5 years old: syntax is close to adult style, 5-6 word sentences 

Peer relationships:
Toddler: parallel play 
Preschoolers: more interactive and social, imaginary play 

Body image:
Masturbation starts around 3-4 years old 

Theories:

Erikson	Industry
team sports/cooperation
Master social studies, math and reading
sense of competence and accomplishment

Development of a of “superego” or conscious develops during preschool age
	Inferiority
children must learn that they will not be able to master every skill they attempt

Criticism detrimental at this age
Piaget	Concrete operations
More tolerant and perceptive of other’s viewpoint
Children are able to use thought processes to experience events and actions
Judgments made based on reason (conceptual)	Ages 2-4-Starting to realize world outside their own, realizing they can make things happen (shift from egocentric. Belief in “magical” power of words. 
Ages 4-7- Preoperational intuitive thought- starting to understand time concept but limited. Example may understand “after lunch” instead of in 2 hours. 
Kohlberg
(moral development)	Judge an act based on consequences of reward and punishment
They know the rules and behaviors expected of this, but do not understand the reasons behind them
	Can accept the concept of treating others as they would want to be treated.
Judge an act based on intention not just consequences


Piaget: Preoperational thinking (2-4yrs) - problem solving based on what they see directly 
	egocentrism - only about them
	Centration - Focus only on 1 thing at a time
	Animism - things around them are alive
Magical thinking - thoughts are all powerful - their thoughts can cause things to happen

Developmental Assessment:
BP starts at 3 years old or if at high risk 
Hearing and Vision at 4-5 years old
Dentist: first tooth eruption or before 12 months; eruption of permanent teeth start at 5 yrs
3 years: Draw circle, cross and vertical/horizontal lines
4-5 years: Trace cross & copy a square, ties shoelaces
5-6 years: Draw a person, copies a diamond and triangle, can print name

2-4 yrs: Animism and magical thinking
Magical thinking continues into 4-7 years

Screening Tools:
Ages and stages Questionnaire: helps with evaluating fine and gross motor development
M-CHAT: evaluates for autism (used for children 16-30 months)
Early language milestone (ELM): brief screening for speech intelligibility (3-4 years old)

Preschool decision: parents should select a preschool with a play based learning curriculum 

Immediate referral is required for children who stop eating, demonstrate cruelty to animals or other people, are self- harmful, start fires, or talk of harming themselves, their peers or others 

Children with scores below 85 on intelligence scales predictably have more difficulty in school

Language development is the best indicator of cognitive development, language delays may indicate serious issues that require developmental and educational intervention 

Vision screening 5y, 6y, 8y, 10y, 12y. Referral with acuity less than 20/40 (aap guidelines)
Hearing screening 5y, 6y, 8y, 10y. (aap guidelines)

Immunization:
Hep Bx3: NB, 1-2 mths, 	6mths
Hib x4:	 1-2 mths, 4 mths, 6 mths, 12-15 mths
Rotavirus x3: 1-2 mths, 4 mths, 6 mths
PCV x4: 1-2 mths, 4 mths, 6 mths, 12-15 mths
DTaP x5: 1-2 mths, 4 mths, 6 mths, 	15-18 mths, 4yr
Polio x4: 1-2 mths, 4 mths, 6 mths, 	4-6y
MMR x2: 12-15mths, 	4yr
Varicella x2: 12-15mths, 	4yr
Older child
Tdap x 1: 	 11-14yr
Meningitis x2: 11yr, 17yr
HPV x2 (6mths apart): 	11-13yrs
Hep A x2 (6 mths apart): between 12-23mths, recommended before middle school if not had earlier 

Safety
Helmets, seat belts, still keep cleaning supplies out of reach/locked up.

Gross Motor Development
3 years
•Rides a tricycle
•Walks on tiptoes
•Stands on 1 foot for a few seconds
•Broad Jump
4 years
•Catches a ball
•Hops & skips on one foot
•Walks up and down stairs using alternate feet
5 years
•Jumps rope, begins to skate and swim
•Walks backwards heel to toe
•Skips and hops (alternate feet)

Sleep
12 hours at night, no naps but quiet time
Nightmares - During REM sleep, fully awakes, able to be reassured, occurs at end of the night 
Night terrors - No during REM, not aware of others, partial arousal, no memory of dream, earlier in the night

Child Aggression: Not necessarily the behavior itself that is the issue but the frequency, severity, timing. Frustration is the biggest reason they act out. Can also happen if parent is depressed, child is neglected, etc.