Toddler Growth and Development
Toddler is a term to define a child that learns to walk. Normally the term is applied to children one to three years old. The toddler years are ones of rapid change and represent a challenge most for parents. The most dramatic advances occur in language and locomotion, but progress is evident in all areas of cognitive and physical growth and development.
The average 18-month-old has a vocabulary of at least 20 words. Over the next few months, the child will experience a burst in vocabulary. At this time, a toddler can say nouns, names of special people, and a few action words and phrases. At this point, about 50% of what the child says should be intelligible to strangers. At two years of age, the child can combine words, forming simple sentences. Toddlers use language to convey their thoughts and needs (such as hunger and pain).
By the age of three years, the vocabulary increases to about 500 words, and 75% of speech is understandable to strangers. He begins to make complete sentences and experiments with speech and language, varying word usage and changing the intensity, as well as intonation, of speech. He typically now begins several daily "why" questions, characteristic of the preschool years. Toddlers sometimes get frustrated because they do not have the language skills to express themselves. Often they have difficulty separating themselves from their parents and other people who are important to them.
Progress in language development is influenced by environmental factors as well as by innate abilities. Bilingual children, for example, may mix languages initially but ultimately will "choose" in their language skills by 2 to 3 years of age. The timetable for language development is broad, and toddlers may go through different kinds of roadblocks along the way. For instance, many preschoolers think faster than they can talk, so they may have trouble saying certain words or sounds, and may even stutter. However, children often repeat words or phrases as they learn to talk or when they are excited or tired. This is normal for most toddlers and children up to 5 years of age.
Affectivity is a crucial point in the toddler's development. The transition from infancy to toddlerhood is marked by a new drive for independence. Toddlers also begin to develop impulse control. The 18-month-old may have minimal impulse control, but two-year-olds typically exhibit wide variations in impulse control, with the degree of control often varying with the struggle for autonomy. Most three-year-olds have mastered some degree of self-control, in part because they are developing the ability to delay gratification. Positive affectivity includes joy, activity, and smiling. Negative affectivity includes fear, anger, sadness, low soothability. Parental influence for affectivity is very influential at this stage.
After infancy, growth speed slows down in the toddler years. After age two, toddlers gain about 5 lb. (2.26 kg) in weight and 2.5 in. (6.4 cm) in height each year. In comparison, head circumference increases by about 1 in. (2.5 cm) from two to 12 years. Growth does not increase steadily. A toddler's weight can remain the same for some weeks. Increases in height result primarily from growth of the lower extremities and, secondarily, to a lesser extent elongation of the trunk. Body proportions change, with upper-to-lower segment ratios ranging from 1.40 at age two years to 1.15-1.20 at age 5 years. An average 15-month-old girl weighs about 22 lb. (9.9 kg) and stands 31 in. (78.7 cm) tall. Boys tend to be about a pound heavier at 15 months but about the same height. By age two, both will stand about 34 in. (86 cm) tall and weigh about 27 or 28 lb. (12 kg). Growth charts are very useful at this time in order to detect abnormal growth that can be a manifestation of clinical disorders. Height, weight, and head circumference are plot versus the values recorded for national averages for children of the same age and sex. By means of percentiles it is then possible to establish the relative value of the measurements. The 70th percentile for weight, for example, means that 70% of the toddlers of that age and gender, in the United States, are lighter, and 30% are heavier.
With a newly erect posture, a toddler stance often includes lordosis (a forward curvature of the spine) and a protuberant abdomen. The percentage of body fat steadily decreases from 22% at age one year to about 12.5% to 15% at age five years. By the end of toddlerhood, increased muscle tone and decreased body fat give the child the appearance of being more lean and muscular. Gross motor skills also develop rapidly. Complex gross motor patterns develop, while balance and coordination improve. Gross motor development milestones include the ability to stand alone well by 12 months, usually walking well by 12-14 months, the ability to kick a ball forward at about 15-18 months, and the ability to jump in place at 20-24 months. At about age 36 months, toddlers have developed their balance and can stand on one foot briefly.
Toddlers make the transition from the sensory-motor to the preoperational stage, as outlined by the Swiss psychologist Jean Piaget (1896-1980). During the sensory-motor period, knowledge of the world is limited and developing. The infant primarily learns about the world by touching, looking, and listening because its based on physical interactions and physical experiences. Intelligence is demonstrated through motor activity without the use of symbols. In preoperational stage (which has two substages), intelligence is demonstrated through the development of symbolic thinking, language use matures, and memory and imagination are developed, although thinking is done in an illogical, manner. This progression from sensory-motor to symbolic thought occurs typically between 18 and 24 months of age. The child's recognition that one object can represent another becomes more evident during playing. Older toddlers continue to develop symbolic thinking. By age three years, they draw primitive figures that represent known people and the environment. They are not able to take the viewpoint of another person, however; egocentric thinking predominates, and toddlers assume that other people think and feel as they do.
Toddlers come to clinical attention usually because of behavioral, relational, or developmental difficulties. Behavioral disturbances may include aggression, and overactivity. In addition, developmental delays and more subtle physiologic, sensory, and sensory-motor processing problems are also observable during the toddler years.
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