Pediatrics Exam 1

Front 1

Growth Pattern for first 6 months

Back 1

680 g or 1.5 lbs/ month
5-7 ounces/week
2.5 cm or 1 inch/month

Front 2

By 5 months weight should have _____ since birth
By 1 year weight should have ________ since birth

Back 2

doubled
tripled

Front 3

Averages for child @ 6 months

Back 3

average weight is 7.26 kg or 16 lbs, average height 65 cm or 25.5 inches

Front 4

Growth pattern for second 6 months

Back 4

340 g or .75 lbs/month
1.25 cm or .5 inches/month

Front 5

Averages for child @ 1 year

Back 5

average weight 9.75 kg or 21.5 lbs, average height 74 cm or 29 inches

Front 6

Head circumference growth for first 3 months

Back 6

2 cm or 0.75 inches/month

Front 7

Head circumference growth for 4-6 months

Back 7

1 cm or 0.4 inches/month

Front 8

Average head circumference
@ 6 months
@ 1 year

Back 8

43 cm or 17 inches
46 cm or 18 inches

Front 9

Averages for child @ 2 years

Back 9

average weight 12 kg or 26.5 lbs
average height 86.6 cm or 34 inches

Front 10

Growth pattern for toddlers

Back 10

1.8-2.7 kg or 4-6 lbs/year
7.5 cm or 3 inches per year
Head circumference is equal to chest by 1 or 2 years.

Front 11

By 2 years should be _______ the birth weight

Back 11

4 x

Front 12

Growth pattern for Preschooler

Back 12

weight 2-3 kg or 4.5-6.5 lbs/ year height 6.5-9 cm 2.5-3.5 in/ year
Growth rate slows and stabilizes. Physical proportions change- slender but sturdy, graceful & agile, posture erect.
Males and females similar in size

Front 13

Averages for child @ 3 years

Back 13

14.5 kg or 32 lbs
95 cm or 37.5 in

Front 14

Averages for child @ 4 years

Back 14

16.5 kg or 36.5 lbs
103 cm or 40.5 in

Front 15

Averages for child @ 5 years

Back 15

18.5 kg or 41 lbs
110 cm or 43.5 in

Front 16

Growth Patterns for School-Age

Back 16

5 cm or 2 inches/year
2-3 kg or 4.4 to 6.6 lbs/year
Males and females differ little in size (though boys tend to be a little bigger)

Front 17

Averages @ 6 years

Back 17

21 kg or 46.3 lbs
116 cm or 46 inches

Front 18

Averages @ 12 years

Back 18

40 kg or 88.2 lbs
150 cm or 59 inches

Front 19

Growth Patterns for Adolescent Girls

Back 19

7-25 kg 15.5-55 lbs
5-20 cm or 2-8 inches
Physical growth begins early as 9 1/2 and as late as 14 1/2

Front 20

Growth Patterns for Adolescent Boys

Back 20

7-30 kg or 15.5-66 lbs
10-30 cm or 4-12 inches
Physical growth begins as early as 10 1/2 and as late as 16

Front 21

Early Adolescent Changes (general)

Back 21

Ages 11-14: rapidly accelerating growth, reaches peak velocity, secondary sexual characteristics appear

Front 22

Mid-Adolescence Changes (general)

Back 22

Ages 15-17: decelerating growth rate in girls, stature reaches 95% of adult height, secondary sexual characteristics well advanced

Front 23

Late Adolescent Changes (general)

Back 23

ages 18-20: physically mature, structure and reproductive growth almost complete

Front 24

Girls grow _____ yrs after menarche
Boys grow until ___________

Back 24

2-2.5
18-20 years old

Front 25

Gross Motor Development @ Birth

Back 25

a little head control

Front 26

Gross Motor Development @ 3 months

Back 26

can hold head beyond plane of the body

Front 27

Gross Motor Development @ 4 months

Back 27

lifts head and front portion of chest approx. 90 degrees above table w weight on forearm.
Able to sit with assistance (convex lumbar curve appears)

Front 28

Gross Motor Development @ 5 months

Back 28

willfully turns from abdomen to back

Front 29

Gross Motor Development @ 6 months

Back 29

rolls over

Front 30

Gross Motor Development @ 7 months

Back 30

sits alone (stomach control) but leans on hands for support

Front 31

Gross Motor Development @ 8 months

Back 31

sits well unsupported and explores surroundings in this position

Front 32

Gross Motor Development @ 10 months

Back 32

moves from prone to sitting

Front 33

Gross Motor Development @ 12 months

Back 33

walks

Front 34

Locomotion @ 6-7 months

Back 34

crawling (on belly)

Front 35

Locomotion @ 9 months

Back 35

creeping (belly off the floor)

Front 36

Locomotion @ 11 months

Back 36

walk with assist

Front 37

Locomotion @ 12 months

Back 37

walk alone

Front 38

Gross Motor Development @ 12-13 months

Back 38

walks alone

Front 39

Gross Motor Development @ 18 months

Back 39

can run but fall easily

Front 40

Gross Motor Development @ 2 years

Back 40

walks up and down stairs

Front 41

Gross Motor Development @ 2 1/2 years

Back 41

jumps using both feet, stand on one foot for a second, few tiptoe steps

Front 42

Gross Motor Development @ end of 2nd year

Back 42

stand on one foot, walk on tip toe, stairs using alternate feet

Front 43

Gross Motor Development @ 3 years/36 months

Back 43

walking, running, jumping, climbing

Front 44

Gross Motor Development @ 4 years

Back 44

skips and hops on one foot, catches ball

Front 45

Gross Motor Development @ 5 years

Back 45

skips and alternate feet, jumps rope, learns to skate and swim

Front 46

Fine Motor Development @ 2-3 months

Back 46

grasping occurs as a reflex, gradually becomes voluntary

Front 47

Fine Motor Development @ 5 months

Back 47

able to grasp an object voluntarily

Front 48

Fine Motor Development @ 7 months

Back 48

transfers objects between hands

Front 49

Fine Motor Development @ 8-9 months

Back 49

crude pincer grasp

Front 50

Fine Motor Development @ 10 months

Back 50

pincer grasp established, will let go of object and offer it to someone

Front 51

Fine Motor Development @ 11 months

Back 51

progresses to neat pincer grasp, places and removes objects from container

Front 52

Fine Motor Development @ 12 months

Back 52

builds 2 block tower

Front 53

Fine Motor Development @ 15 months

Back 53

can drop a pellet into a narrow necked bottle, throwing and retrieve objects,

Front 54

Fine Motor Development @ 18 months

Back 54

throw ball overhand without losing balance

Front 55

Fine Motor Development @ Preschool

Back 55

Improved skills with drawing, writing and holding a pencil. Draws shapes, letters,

Front 56

Fine Motor Development @ 4-5 years

Back 56

enter pictorial stage (can draw recognizable objects) trace and copy square

Front 57

Fine Motor Development @ 5-6 years

Back 57

masters triangle and diamond

Front 58

Language @ birth

Back 58

crying is the first verbal communication
At first conveys a message of urgency and signals displeasure
Affects development of infant-parent relationship (usually b/c of absence)

Front 59

Language @ 5-6 weeks

Back 59

early vocalizations, throaty sounds

Front 60

Language @ 2 months

Back 60

vocalizes single vowel sounds

Front 61

Language @ 3-4 months

Back 61

coos, giggles, laughs, with n, k, g, p, b

Front 62

Language @ 6 months

Back 62

imitates sounds, adds t, d, w, combines syllables (dada)

Front 63

Language @ 9-10 months

Back 63

understands ‘no’

Front 64

Language @ 10-11 months

Back 64

ascribes meaning to words

Front 65

Language @ 1 year

Back 65

3-5 words with meaning may understand as many as 100 words

Front 66

Language @ 2 years

Back 66

300 words with greater understanding
Multiword sentences of 2-3 words

Front 67

Language @ 3 years

Back 67

Simple sentences, masters grammatical rules , acquires 5-6 words daily

Front 68

Language @ 4-5 years

Back 68

four to five word sentences, end of 5th year over 2100 words, follows simple directional commands, lots of questions and will repeat until they get an answer

Front 69

Language @ 6 years

Back 69

understands all parts of speech, identifies opposites, can define simple objects

Front 70

Language @ School Age

Back 70

Efficient language skills
Important linguistic accomplishments
Correct syntax, improved grammar, word usage (elemenatary school) Metalinguistic awareness- ability to think about language and to comment on properties, appreciates jokes, riddles and puns.

Front 71

Nutritional Needs for Infant

Back 71

Breast milk only for first 6 months
Fetal iron stores depleted by 4-6 months

Front 72

Introduction to Solid Foods

Back 72

At about 6 months
Introduce foods at intervals of 4-7 days to allow for identification of possible allergies. Iron fortified rice cereal is best to start
Avoid starting too early. GI tract enzymes aren’t ready & linked to allergies

Front 73

Fluoride Supplements

Back 73

during second 6 months if not in water until 3 years

Front 74

Dental Care for Infant

Back 74

Teeth begin to come in at 4-6 months (months-6)
Initially wipe with damp cloth
Oral Exam by 6 months by pediatrician
First dental visit at 1 year

Front 75

Nutrition Needs for Toddler

Back 75

Mealtimes should be enjoyable. Calling them 15 minutes before mealtimes help to settle their active minds, but don’t need to sit and eat with parents. Grazing is a good way to ensure proper nutrition.

Front 76

Dental Care for Toddler

Back 76

removal of plaque- brushing and flossing, most effective when done by parents, best before bed and between meals.
Should receive fluoride supplements until 3 years.
Low-Cariogenic diet- sugars, raisins, honey, syrups and complex carbs

Front 77

Nutritional Needs for Preschooler

Back 77

requires about 90 kcal/kg, average daily intake of 1800 calories, protein needs increase
Fluid requirement about 100 ml/kg daily.
My Pyramid application.
Concerns about childhood obesity, calculate BMI, if under 5%- underweight, if between 85%-95% at risk for overweight, if over 95%- overweight

Front 78

Nutritional Needs for School-Age children

Back 78

Importance of balanced diet to promote growth.
Quality of diet related to family’s eating pattern.
Fast food concerns & school lunches raise concern: more independent from parental influences and outside

Front 79

Nutritional Needs for Adolescent

Back 79

Double the need for zinc, iron, calcium and protein, growing independence, peer acceptability, concerns with appearance & active lifestyle affect eating habits, food choices and nutrient intake.
Excess of calories and fats is common along with inadequate intake of certain vitamins. Girls in particular generally need more iron. Help youth acquire the power, authority and opportunities to make choices that increase likelihood of creating positive health choices. Classroom programs that address health related issues (eating) are helpful

Front 80

Psychosocial Stage: Infant

Back 80

Developing a sense of trust (birth to 1 year)
Trust vs. Mistrust: infants trust their needs will be met.
Importance of parent-child relationship: consistency of care. Must delay gratification but not for too long. If no delay- child won’t test ability to control environment. If too long- child develops frustration and mistrust. Tactile important for relationship with caregiver

Front 81

Developing a sense of trust

Back 81

Erikson's Stage 1
Birth to 1 year
Trust vs. Mistrust
Importance of parent-child relationship: consistency of care. Must delay gratification but not for too long. If no delay- child won’t test ability to control environment. If too long- child develops frustration and mistrust. Tactile important for relationship with caregiver

Front 82

Psychosocial Stages of Toddler

Back 82

Developing a Sense of Autonomy. a.k.a- the age of independence
Autonomy vs. Shame & Doubt:
Negativism- “no” “me do” rapid mood swings w strong emotions, frustrated.
Ritualism- kid needs to maintain sameness and reliability for comfort (hospitalizations can really throw them off)
Ego- thought of as reason/common sense, struggles with id, tolerate frustration, learns socially acceptable ways of interacting with environment, ability to delay gratification Superego- thought of as conscience, moral development, aware of ability to fail,self mastery helps with confidence

Front 83

Developing a Sense of Autonomy. a.k.a- the age of independence

Back 83

Toddlers
Autonomy vs. Shame & Doubt:
Negativism- “no” “me do” rapid mood swings w strong emotions, frustrated.
Ritualism- kid needs to maintain sameness and reliability for comfort (hospitalizations can really throw them off)
Ego- thought of as reason/common sense, struggles with id, tolerate frustration, learns socially acceptable ways of interacting with environment, ability to delay gratification Superego- thought of as conscience, moral development, aware of ability to fail,self mastery helps with confidence

Front 84

Psychosocial Stages of Preschooler

Back 84

Developing a sense of initiative
Initiative vs. Guilt:
wants to try new things and do it well, best when met with praise, if not- develop guilt
Development of Superego (conscience)- major task for preschoolers. Learn right from wrong- begins morality, aware of appropriate behavior, more aware of danger and can be relied on to listen and obey.

Front 85

Developing a sense of initiative

Back 85

Preschoolers
Initiative vs. Guilt- wants to try new things and do it well, best when met with praise, if not- develop guilt
Development of Superego (conscience)- major task for preschoolers. Learn right from wrong- begins morality, aware of appropriate behavior, more aware of danger and can be relied on to listen and obey.

Front 86

Psychosocial Stages of School-Age Child

Back 86

Developing a sense of industry-Inferiority vs. Industry:
feelings may derive from self or social environment,may occur if incapable or unprepared to assume the responsibilities associated with developing a sense of accomplishment, eager to develop skills and participate in meaningful and socially useful work, all children feel a sense of inferiority regarding skills they cannot master
Acquires a sense of personal and interpersonal competence, growing sense of independence, peer approval is strong motivator
Relationships center around same-sex peers
Freud describes as ‘latency’ of psychosexual development
Sense of accomplishment also involves ability to cooperate, compete and to cope with others

Front 87

Developing a sense of industry

Back 87

School Age
Inferiority vs. Industry:
feelings may derive from self or social environment,may occur if incapable or unprepared to assume the responsibilities associated with developing a sense of accomplishment, eager to develop skills and participate in meaningful and socially useful work, all children feel a sense of inferiority regarding skills they cannot master
Acquires a sense of personal and interpersonal competence, growing sense of independence, peer approval is strong motivator
Relationships center around same-sex peers
Freud describes as ‘latency’ of psychosexual development
Sense of accomplishment also involves ability to cooperate, compete and to cope with others

Front 88

Psychosocial Stages of Adolescent

Back 88

Identity development
Development of Autonomy
Achievement
Sexuality
Intimacy

Front 89

Identity Development in Adolescence

Back 89

Part of Psychosocial stage:
main task for adolescent years, social forces play large role, society determines range of available alternatives open to young people in identity formation. Progress can be measured by status of personal commitments in occupational, social and ideological domains

Front 90

Development of Autonomy in Adolescence

Back 90

Part of Psychosocial stage:
Emotional, cognitive & behavioral components Becomes more emotionally independent from parents, take responsibility for own actions but turns to others for advice when appropriate, conformity to parents then peers declines.

Front 91

Sense of Achievement in Adolescent

Back 91

Part of Psychosocial stage:
concerns development of motives, capabilities, interests, and behaviors related to evaluative situations, focuses academic performance and future plans

Front 92

Coming to Terms with Sexuality

Back 92

Part of Psychosocial stage:
come to terms with hormonal influences, physiologic manifestations and physical changes, will have changes in sexual motivations and feelings, as they mature- better able to think about risks, able to think about sexual identity

Front 93

Developing Intimacy

Back 93

Part of Psychosocial stage:
true intimate relationships emerge at adolescence, emotional attachment- concerned about wellbeing, share private info, sensitive topics & common interests, intimate relationships with opposite sex develop in late adolescence.

Front 94

Cognitive Development of Infant

Back 94

Sensorimotor phase: Learns through exposure of 5 sense and movement
3 main events: Infant separates self from other objects in environment. Achieves object permanence. Uses symbols or mental representations.

Front 95

Sensorimotor Phase

Back 95

Learns through exposure of 5 sense and movement
3 main events: Infant separates self from other objects in environment. Achieves object permanence. Uses symbols or mental representations.

Front 96

Cognitive Development of Toddler

Back 96

Sensorimotor phase- aware of causal relationships between 2 events(light switch), learns spatial relationships (round objects can fit into round holes, mental symbolism (language), tolerates separation from parents, SELF CENTERED-taking toys from other kids,
Preconceptual phase- 2-4 years, transition between self-satisfying behavior and socialized relationships, egocentric language, why’s and how’s,

Front 97

Sensorimotor phase

Back 97

about 1-2 years
aware of causal relationships between 2 events(light switch), learns spatial relationships (round objects can fit into round holes, mental symbolism (language), tolerates separation from parents, SELF CENTERED-taking toys from other kids,

Front 98

Preconceptual phase

Back 98

2-4 years, transition between self-satisfying behavior and socialized relationships, egocentric language, why’s and how’s,

Front 99

Cognitive Development of Preschooler

Back 99

Preoperational Phase: causality, time (best when related to an event), magical thinking (believe their thinking causes things to happen)
logical thinking- able to think and verbalize their mental processes without having to act out their thinking, can only think of one idea at a time and are unable, all types of play hold therapeutic and communicative value, can explain a concept but with little actual understanding.

Front 100

Preoperational Phase

Back 100

Preschooler
causality, time (best when related to an event), magical thinking (believe their thinking causes things to happen)
logical thinking- able to think and verbalize their mental processes without having to act out their thinking, can only think of one idea at a time and are unable, all types of play hold therapeutic and communicative value, can explain a concept but with little actual understanding.

Front 101

Cognitive Development of School-Age child

Back 101

Concrete Operations: Age 7 to 11, uses thought process to experience events/actions, develop understanding of relationships between things and ideas, able to make judgments based on thinking, understands reversibility (able to tell story backwards)
See things from another’s POV, become more sensitive to fact that others do not always perceive events like they do, reduction of egocentricity helps for logical thought, and development and maturation of morality.
Masters concept of conservation- helps with understanding of math, first understand conservation of numbers, then substance then liquids, mass and length, finally weight and lastly, volume or displacement.
Classification skills- ability to group objects logically. Then understand relational terms (bigger, smaller, darker, lighter)
Most significant: develop ability to read

Front 102

Concrete Operations

Back 102

Age 7 to 11, uses thought process to experience events/actions, develop understanding of relationships between things and ideas, able to make judgments based on thinking, understands reversibility (able to tell story backwards)
See things from another’s POV, become more sensitive to fact that others do not always perceive events like they do, reduction of egocentricity helps for logical thought, and development and maturation of morality.
Masters concept of conservation- helps with understanding of math, first understand conservation of numbers, then substance then liquids, mass and length, finally weight and lastly, volume or displacement.
Classification skills- ability to group objects logically. Then understand relational terms (bigger, smaller, darker, lighter)
Most significant: develop ability to read

Front 103

Cognitive Development of Adolescents

Back 103

Emergence of Formal Operational Thought: 11-14 years, abstract terms, possibilities and hypothesis, decision-making abilities increase. May not use formal operational thought and reasoned decision making all the time.
Conceptions of self: adolescent egocentrism, self-absorbed
Health-related beliefs: Imaginary audience (everyone is watching me) and personal fable (won’t happen to me) Understanding of others’ thoughts and feelings, mutual role-taking, can effect health related choices.

Front 104

Formal Operational Thought

Back 104

11-14 years, abstract terms, possibilities and hypothesis, decision-making abilities increase. May not use formal operational thought and reasoned decision making all the time.
Conceptions of self: adolescent egocentrism, self-absorbed
Health-related beliefs: Imaginary audience (everyone is watching me) and personal fable (won’t happen to me) Understanding of others’ thoughts and feelings, mutual role-taking, can effect health related choices.

Front 105

Moral Development of Toddler

Back 105

Pre-conventional or Pre-moral Level
Punishment and obedience orientation, motivation is based on reward or punishment. They have little, if any, for why something is wrong.
36 months- development aspects of conscience may be present.

Front 106

Moral Development of Preschooler

Back 106

Pre-conventional or Pre-moral level: 2-4 years: judge good or bad by if they receive punishment. 4-7 years: actions are directed toward satisfyin their needs and less commonly, needs of others.
Punishment and obedience orientation- LOVES to tattle tale

Front 107

Moral Development of School Age Child

Back 107

Development of conscience and moral standards
6-7 years: reward and punishment guides choices (don’t understand reasons)
Older age- able to judge and act by the intentions that prompted it, rules and judgments become more founded on needs and desires of others

Front 108

Moral Development of Adolescent

Back 108

Develops personal value system, Parallels advances in reasoning and social cognition, conventional level of moral reasoning, principled moral reasoning, question absolutes and rules, want things to be ‘fair’

Front 109

Safety Concerns for Infants

Back 109

most concerned with falls (furniture, stairs), ingestion injuries (once mobile), and burns. Diligence in supervision
Other issues: aspiration of foreign objects (foods and other objects, toys more common) suffocation (latex balloons, etc.) MVA (use proper rear facing seats) drowning & bodily damage

Front 110

Safety Concerns for Toddlers

Back 110

MVA’s- car seat safety, drowning, burns, poisoning, falls, aspiration and suffocations, bodily damage. Toy safety- adults responsibility.

Front 111

Safety Concerns for Preschoolers

Back 111

poisoning, pedestrian motor vehicle accidents, seat belts, bike helmets, emphasis on protection and education for safety. Less prone to falls, less reckless, aware of potential dangers

Front 112

Safety Concerns for School-Age Child

Back 112

Pedestrian and passenger MVA’s most common, bike helmets, appropriate safety equipment for all sports. Boy more likely to be injured or die than girls.
Higher incidence of transportation related injuries than younger ages, higher bike injury. Lots of cuts, bruises, scrapes, breaks, strains and sprains.

Front 113

Safety Concerns for Adolescent

Back 113

Biggest concerns are unintentional injury, homicide and suicide. MVAs largest cause, injury prevention: don’t walk alone at night, if someone is following you get to where there are people, promote safe driving, wear seat belt, discourage racing, dangers of hitch-hikers and drugs/alchohol, basic water safety, discourage tobacco, educate regarding poisons, proper body mechanics in sports, assess for depression and teach sex responsibilities

Front 114

Anticipatory Guidelines for Birth- 6 Months

Back 114

teach about car safety, understand need for adjustment, teach care of infant & understanding needs, cannot spoil baby, help understand needs for stimulation, stress need for immunizations, plan anticipatory guidelines for safety, prep for intro of solid foods.

Front 115

Anticipatory Guidelines for 6+ months

Back 115

prep parents for “stranger anxiety,” encourage clinging and avoid long separation, guide about discipline, encourage negative voice & eye contact rather than physical punishment, encourage most attention when behaving well, teach injury prevention, discuss readiness for weaning, explore feelings about sleep patterns

Front 116

Anticipatory Guidelines for Toddler: 12-18 Months

Back 116

prep for expected behavioral changes (ritualism/negativism) assess present feeding habits, encourage weaning from bottle, inform about physiologic anorexia, assess sleep patterns (no bottle, procrastination behaviors that delay sleep) prep for dangers (MVAs, poisoning, falls, etc.) discuss need for firm but gentle discipline, stress importance of brief, periodic child-parent separations, discuss toys that help develop skills, dental supervision

Front 117

Anticipatory Guidelines for Toddler: 18-24 months

Back 117

stress importance of peer companionship play, need for prep for new sibling, prep for new experiences, discuss discipline methods and parents feelings to child’s negativism, discuss signs for readiness of toilet training, development of fears, signs of regression during stress, ability to separate from parents, allow parents to discuss feelings, point out expected changes within the next year

Front 118

Anticipatory Guidelines for Toddler: 24-36 months

Back 118

discuss importance of imitation and domestic mimicry and need to include child in activities, approaches to toilet training, stress uniqueness of thought process, must still use structured discipline and concrete, investigate preschools and daycare center toward completion of 2nd year.

Front 119

Anticipatory Guidelines for Preschooler: 3 years

Back 119

prep for child’s increasing interest in widening personal relationships, encourage enrollment in preschool or other social activities, emphasize importance of setting limits, prep parents to expect exaggerated tension-reduction behaviors, such as need for “security blanket,” encourage to offer choices, expect changes at 3 ½ years, prep parents to handle anger constructively and appropriately, expect more stable appetite, injury prevention.

Front 120

Physiologic Anorexia

Back 120

Child goes through periods of eating a lot and not. correlate with growth spurts

Front 121

Anticipatory Guidelines for Preschooler: 4 years

Back 121

prep for more aggressive behavior (motor activity and bad language) prep to expect resistance to authority, explore parent’s feelings, suggest respite for parents, prep for increase in sexual curiosity, realistic limits on behavior and appropriate discipline, prep for imaginative ‘tall tales’ and imaginary friends, expect nightmares

Front 122

Anticipatory Guidelines for Preschooler: 5 years

Back 122

age of calm, help prep for entrance into school, update immunizations, establish ‘stranger danger’ rules, suggest swim lessons, limit tv and preview shows for inappropriate content.

Front 123

Anticipatory Guidelines for School Age: 6 years

Back 123

Parent’s adjust to child increasing independence, provide support as unobtrusively as possible, child moves from narrow family relationship to broader world of relationships.
expect strong food preferences, increasing appetite, child may experience mood changes, susceptible to illness, needs privacy, increasing interest in things outside the home, needs to interact with peers.

Front 124

Anticipatory Guidelines for School Age: 7-10 years

Back 124

allergies may increase, expect increase in minor injuries, use caution in selecting and maintaining sports equipment and reemphasize safety, expect increase in involvement with peers and interest in activities outside the home, need to encourage independence while keeping limit setting and discipline, prep mom to expect more demands at 8 yrs. Prep father for increasing admiration, prep parents for prepubescent changes in girls.

Front 125

Anticipatory Guidelines for School Age: 11-12 years

Back 125

prep for body changes of pubescence, expect growth spurt in girls, adequate sex ed with accurate info, prep parents to expect energetic but stormy behavior at 11 yrs with more even temper at 12 years, encourage child’s desire to “grow up” but allow regression when needed, prep for an increase in masturbation, need for rest may increase, education child about experimentation with potentially harmful activities.

Front 126

Anticipatory Guidelines for Adolescent:

Back 126

Accept child as individual, respect their ideas, likes and dislikes, be involved with school functions and attended performances or games, listen and be open to their views, avoid criticism, provide clear limits, respect their privacy, share feelings of joy/sorrow, use clear communication.

Front 127

Fears and Sleep Patterns: Infant

Back 127

concerns are common, infant should be active while awake and sleep a sufficient amount of time. Colic is the common cause of sleep issues. Others may be attributed to maternal depression. Prevent by creating night time rituals. Stay with child until drowsy then put in own crib to sleep

Front 128

Fears and Sleep Patterns: Toddler

Back 128

averages about 12 hrs of sleep, problems of going to bed and falling asleep commonly related to fear of separation. Rituals and stuffed animals are helpful.

Front 129

Fears and Sleep Patterns: Preschooler

Back 129

night terrors (possibly triggered by stress), animism (lifelike characteristics to inanimate objects), techniques to over coming fears. Fear of the dark, being alone, large/scary animals (dogs and snakes), ghosts, things associated with pain, exposing to fear in a safe environment may help

Front 130

Fear and Sleep Patterns: School-Age

Back 130

anxiety symptoms: fear of dark, excessive worry about past behavior, self-conscious, social withdrawal, excessive need for reassurance. Fear being hurt or kidnapped. Most new fears are related to school and family.

Front 131

Play Behaviors: Infant

Back 131

play is a major socializing agent. Separation anxiety kicks in at 5-6 months.

Front 132

Play Behaviors: Toddler

Back 132

parallel play, imitation, tactile play is important selecting toys, toy safety- consumer product safety commission, Canadian toy testing counsel

Front 133

Play Behaviors: Preschool

Back 133

Associative play, imitation (dress up and ‘house’), imaginary playmates, mutual play with parents love puzzles, blocks, paints, books, and other toys that help with fine and gross motor development,

Front 134

Play Behaviors: School-Age

Back 134

Involves physical skill, intellectual ability and fantasy. Children form cliques, groups, clubs, secret societies. Use rules and rituals, see need for rules in games they play
Team play help learn subordinate personal goals to group goals, makes child accountable, learn concept of interdependence and reliance on one another, division of labor, contributes to social, intellectual and skill growth
Quiet activities- reading becomes increasingly satisfying, creative things like cooking, sewing, carpentry

Front 135

"Play" Behaviors of Adolescent

Back 135

Peers are significant in socialization, development. Value is placed on peer relationships

Front 136

Early Puberty Norms for Girls

Back 136

Begins 8 1/2- 12 years
earliest changes being of the nipple and areola and development of small bud of breast tissue, 2-6 months later appearance of pubic hair and may be an increase in vaginal discharge.

Front 137

Mid-Puberty Norms for Girls

Back 137

breast enlargement occurs and pubic hair progresses to more adult like (covering mons pubis and labia majora) reach peak height & weight velocity.

Front 138

Late Puberty Norms for Girls

Back 138

first menstrual period (scanty and irregular) which may not be accompanied by ovulation, regular periods begin 6-14 months after, occurs 2 years after breast buds appear & 9 months after peak height velocity and 3 months after peak weight velocity.

Front 139

Early Puberty Norms for Boys

Back 139

Begins 91/2- 14
testicular enlargement w thinning, reddening and increasing looseness of scrotum, initial appearance of pubic hair

Front 140

Mid-Puberty Norms for Boys

Back 140

penile enlargement begins, testicular enlargement & pubic hair growth continue, increasing muscularity, early voice changes, development of early facial hair, may be come gynecomastia (breast enlargement & tenderness) near end- spurts in heigh and weight

Front 141

Late Puberty Norms for Boys

Back 141

definite increase in length and width of penis, testicular enlargment continues, first ejaculation occurs, axillary hair develops, facial hair extends to cover the anterior neck, final voice changes occur