The Toddler and Preschooler

1
The Toddler and Preschooler
2
Toddler

• starts and ends in the terrible twos which are
  manifested by the childs ambivalent struggle for
  autonomy
• 18 months to 3 years

3
Neurological

• Motor
• look out!
• Feeding and Toilet Training
• Do not engage in a power struggle with the toddler

4
Cognitive

• Language
• By age 3, most children speak in 3-word,
  subject-verb-object sentences
• Assessment is indicated if an 18-month-old uses
  no words (or just mama or dada) or a
  two-year-old has speech which is unintelligible
  to parents
• Exploration

5
Anal Stage

• struggle of wills between parent and child
• the anal personality

6
Object Relations

• Rapprochement
• Transitional Object
• Practicing
• Social Referencing
• Object Constancy
• Consolidation

7
Autonomy vs. Shame Doubt

• temper tantrums
• consistent parenting

8
Gender Identity

• established by 30 months

9
Social Development

• Parallel play until 30 months
• Associative play by 36 months

10
Neurological Development
11
Motor Development

• By 18 months, children can climb stairs, run
  awkwardly, and throw a ball
• by 24 months, children can run well

12
Feeding

• Toddlers generally experience a dramatic decrease
  in appetite due to decreased nutritional needs
  and increased interest in other activities
• Parents should avoid turning meals into power
  struggles

13
Toilet Training Prerequisites

• regularity of bladder and bowel function
• ability to sense bladder and rectal fullness
• ability to control the sphincter muscles
• the psychological ability to delay
• the wish to please parents
• the ability to communicate and use the toilet
• motor ability to walk, stoop, remove clothing
  easily

14
Toilet Training

• Parents should avoid turning toilet training into
  a power struggle
• Most children establish control of urination
  during the day by age 2.5 and at night by 3.5-4
  years
• Nocturesis tends to be familial
• Almost all children have achieved bowel control
  by age 4

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Cognitive Development
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Language

• 12-18 months
• jargon
• unintelligible sounds resembling speech
• similar to babbling but with a variety of vowels
  and consonants
• 17-21 months
• telegraphic speech
• two word sentences such as Want Candy!

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Language (cont)

• 18-25 months
• 50 word spoken vocabulary
• 500 word receptive vocabulary
• 24-36 months
• 200 word spoken vocabulary
• speech is usually in three-word sentences

18
Language Disorder

• Assessment is warranted if
• 18 month-old uses no words or just mama or
  dada
• 2 year-old is not putting 2 words together, has a
  vocabulary of lt20 words, has speech which is
  unintelligible to parents, or does not understand
  commands or questions without gestures
• Causes of delay include deafness, aphasia, mental
  retardation, autism, and developmental language
  disorder

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Psychosocial Development
20
Anal Stage

• struggle of wills between mother and child
• Freud thought that this stage was characterized
  by the infants realization of me and not me
  through conscious defecation and subsequent
  disposal of waste

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Anal Stage (continued)

• Freud thought that children whose parents were
  overly aggressive in toilet-training them would
  develop harsh, overly demanding personalities
  characterized as compulsively neat, rigid,
  domineering, and pedantic (the anal personality
  or Ophthalmologist)

22
Object Relations - Practicing

• 7-16 months
• social referencing allows the child to look to
  the parent for appropriate behavior and response
  to novelty
• autonomous ego functions in the presence of the
  caregiver
• as object permanence develops, the child can
  carry an internal representation of the caregiver
  with him

23
Object Relations - Rapprochement

• 16-24 months
• childs ambivalent attempts to be independent
  while wanting to be with caregiver
• child pushes away when held and pulls close when
  placed down
• self-image is completely dependent on the
  caregiver
• children frequently benefit from the presence of
  a transitional object

24
Object Relations - Object Constancy

• 24-36 months
• child begins to consolidate his internal
  representation of caregiver as good and
  trustworthy
• child is able to extend his trust to other adults
• better frustration tolerance with development of
  ego functions
• understands rules and is able to follow them for
  personal safety

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Autonomy vs. Shame Doubt

• Largely synonymous with Object Constancy
• Requires the ability to conform behavior within
  externally applied guidelines, thus avoiding
  parental censure and ensuring relative autonomy
• Overly restrictive parenting does not allow the
  child to govern himself

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Autonomy vs. Shame Doubt

• Shame arises from an inability to avoid
  punishment
• Temper Tantrums and Negativism are normal
• Parents must not over-react to these normal
  behaviors

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Discipline

• Positive Reinforcement
• should be delivered with positive affect
• Negative Reinforcement or Punishment
• should be delivered with neutral affect

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Discipline

• Corporal Punishment
• especially problematic with toddlers as they
  extensively use social referencing and model
  their behavior on the behavior they observe
• Time Out
• social referencing makes this particularly
  useful as children learn to remove themselves
  from particularly stressful environments

29
Gender Identity

• Appears at 18 months is often established by
  24-30 months
• Usually integrated by age 4
• Adults tend to treat boys and girls differently
  from birth

30
Social Development

• Parallel Play
• occurs 24-30 months
• characterized by solitary play conducted in pairs
• Associative Play
• Occurs 30-36 months
• characterized by imitative, similar play
  side-by-side

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Preschool

• 3 years to 6 years
• Characterized by extensive exploration of the
  environment

32
Neurological Development

• Motor skills are rapidly acquired and refined
  during this periods

33
Cognitive Development

• Speech and Language
• language development allows pre-schoolers to
  verbalize their negative feelings
• six-year-olds have essentially grammatical speech
• Pre-Operational Stage
• Conservation develops by school-age
• Prior to that, normal children have thought
  processes that would be psychotic in an adult

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Psychosocial Development

• Moral Development
• Imminent Justice and the Inevitability of
  Punishment
• Moral Absolutism
• Phallic Stage
• Oedipus Complex

35
Social Development

• Development of Empathy
• Adult roles and practices are mirrored

36
Intiative vs. Guilt

• Development of creativity/innovation

37
Neurological Development
38
Gross Motor Development

• Three-year-olds
• stand on one foot, jump, run smoothly, climb
  stairs using alternating feet
• can usually ride a tricycle
• Four-year-olds
• can climb a jungle gym and throw overhand
• Five-year-olds
• can skip and hop on one foot
• handedness is usually established

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Fine Motor Development

• Three-year-olds
• can build a tower of 9 or 10 blocks
• can draw a circle
• Four-year-olds
• can button lace, feed themselves neatly, pour
  from a pitcher, dress and wash themselves
• can copy a cross and draw a basic man
• Five-year-olds
• can draw a recognizable man and copy a square

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Cognitive Development
41
Language Development

• Permits mastery of negative feelings, yielding
  better impulse-control
• Overt aggression diminishes as language skills
  increase
• Three- to Six-year-olds develop new vocabulary at
  a rate of 9 new words a day

42
Language Development

• Three-year-olds
• ask constant questions just for the sake of
  talking
• Four-year-olds
• immature articulation
• speech is largely intelligible to strangers and
  occurs in several word sentences

43
Language Development

• Five-year-olds
• articulation is clear
• essential rules of grammar are understood
• Six-year-olds
• syntax is essentially adult
• language development may be ahead of the ability
  to understand concepts

44
Pre-Operational Stage

• extends from 12 months to 7 years
• characterized by magical, illogical, intuitive
  view of the world
• cause and effect is not clear
• Problem-solving is by trial and error

45
Pre-Operational Stage

• Egocentricism
• Animism
• Transductive Thinking
• Magical Thinking

46
Psychosocial Development
47
Moral Development

• Imminent Justice and Inevitability of Punishment
• Guilt is determined by the amount of damage not
  the intent
• Children naturally split good from bad and see
  things as good or bad, not with characteristics
  of each

48
Phallic Stage

• Oedipus or Electra Complex
• the child expresses jealousy and feels rivalry
  toward the same-sex parent
• this conflict resolves when the child identifies
  with the same-sex parent
• More generally, the child learns that he or she
  must conform to societal rules
• Super-Ego
• Arises from the resolution of the Oedipus Complex
• The child carries an internal representation of
  what is expected or right to do, but is able to
  choose to do otherwise

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Social Development

• Three-year-olds
• begin to develop empathy
• Four-year-olds
• are able to engage in cooperative and small-group
  play
• have difficulty integrating the wants of others
  with their own wants

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Social Development

• Five-year-olds
• able to plan and execute group projects and
  dramatic play
• with development of empathy, children become able
  to lead others
• Overly aggressive children are rejected by their
  peers, which is a strong predictor of later
  psychopathology

51
Initiative vs. Guilt

• Guilt arises if parents are overly authoritarian
  and stifle their childrens creativity
• Initiative occurs when children are allowed to
  plan and execute activities within reasonable
  limits