Positive Parenting Tips for Toddlers

Talking To Toddlers

Talking to Toddlers is a program that offers effective parenting tips to help shape behavior in toddlers. It is a creation of Chris Thompson, a parenting professional and certified NLP practitioner. No doubt he has all it takes to address the issue of parenting. The program helps parents understand problems often experienced by children, include the reasons behind their behaviors. In most cases, parents communicate to children in inappropriate ways without know. This may lead kids to behave contrary to parents expectations. This is among the major problems this program helps to fix. You will be able to learn about the word you often misuse and evoke bad reactions from kids. Kids are often misunderstood and this makes it difficult for them to learn. This guide has helped thousands of parents across the world and it is going to help you too. Buy it today and start learning the best strategies you can use to train your children. Read more...

Talking To Toddlers Summary


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Contents: Audio Course
Author: Chris Thompson
Official Website: talkingtotoddlers.com
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Highly Recommended

I've really worked on the chapters in this book and can only say that if you put in the time you will never revert back to your old methods.

My opinion on this e-book is, if you do not have this e-book in your collection, your collection is incomplete. I have no regrets for purchasing this.

Toddler 18 to 36 Months

PHYSICAL ASPECTS Decelerating growth rate and decreased appetite are seen during this period, although the head approaches its adult size. The 20 primary teeth are in place by 36 months, and dental caries are common. High center of gravity, mobility, and curiosity lead to increasing risk for head and orthopedic injuries. A toddler's open growth plates are far more likely to sustain epiphyseal fracture than ligamentous injury. Traction injuries to the arm will frequently result in subluxation of the annular ligament of the radial head (i.e., nursemaid's elbow ). NEUROLOGIC ASPECTS By 18 months of age, most children can walk well, feed themselves, follow simple commands, and use four to six words to indicate their desires. Stranger anxiety peaks at this age but remains important throughout the toddler period. By 24 months, most children can run, climb stairs, and speak with three-word phrases, although only 50 percent of speech is intelligible to nonfamily members. Toddlers understand...

Toddler Diarrhea

One troublesome diet-related problem occurring in preschool children is 'toddler diarrhea.' Young children are susceptible to gastrointestinal infections because of immature, inexperienced immune systems and poor hygiene from their habit of 'mouthing' almost everything they handle. Children are also prone to develop loose stools in response to minor nongastrointestinal infections. However, some children suffer frequent episodes of loose watery stools with or without increased stool frequency and without evidence of infection. These episodes of diarrhea may last weeks or months. Since it may be difficult to distinguish this diarrhea from other significant gastrointestinal pathology, affected children may be subjected to a lot of unrewarding clinical investigation. Children with toddler diarrhea usually grow normally, unlike most children with significant gastrointestinal pathology. Typically, they are untroubled by their diarrhea although their parents are understandably very concerned...

Childrens Companionship Age Gender and Kinship

Children's age has a strong influence on their choice of companions, much more so than does their gender in the early years. Age-related changes in children's physical, social, and intellectual capacities are necessarily related to changes in their social settings and their companions. For example, infants and toddlers require constant supervision and show dependency behaviors such as seeking comfort, protection, and food from the primary caregiver or designated guardians. They are more likely to be in the company of mothers or other female adults (grandmothers, aunts, or hired caregivers) rather than male adults in almost all cultural communities. The age gap between the children and their companions is also important. When children interact with children who are older than they are by 3 or more years, they tend to display certain dependency behaviors (seeking proximity, exchanging information inquiring, and watching imitating) (Whiting & Edwards, 1988). Toddlers and preschool-aged...

Prevalence of Iron Deficiency and Iron Deficiency Anemia

Data from the US NHANES III (1988-1994) survey, which used a variety of indicators of iron status, showed that 9 of US toddlers were iron deficient and 3 had iron deficiency anemia. Eleven percent of adolescent females and women of reproductive age were iron deficient, and 3-5 of these women had iron deficiency anemia. Iron deficiency in the developed world is more common among low-income minorities.

Parental and Other Caretaker Roles

For the first few years of a child's life, the mother and other close female relatives are the primary caretakers. Fathers may be very loving with their small children and play with toddlers of both genders, but their time with them is limited. Abelam of both genders are generally very affectionate with their children and very indulgent of them. Disciplining small children with physical punishment is very unusual in Abelam society (Scaglion, 1999a). When discipline becomes necessary, scolding or withholding food are more common punishments, and, as the primary caregivers, females are usually the disciplinarians. After the first several years, men take a more active hand in parenting boys, while women continue their primary role in socializing girls. When young girls are of an age to be sexually active, men again take a strong interest in their socialization. Abelam believe that sexual activity may be harmful to yam growth (Scaglion, 1998), and fathers and brothers are accountable for...

Cultural Construction of Gender

Gender identity is expressed by clothing and hairstyle throughout life. A baby's apparel may indicate gender by the shape of the cap if the family is wealthy enough to make such a distinction. Boys ideally wear the typical Andean chullo, a knitted cap with ear flaps, while a girl's knitted cap is more conical with a soft floppy edge and brighter colors. Other baby clothes are quite unisex, with swaddling rags and open diaper skirts for all toddlers. Beyond infancy, headgear always differs by gender, with feminine and masculine styles of brimmed hat added as the children become marriageable adolescents. (Men simply put their brimmed hats over their knitted caps.) Perhaps the best-known Aymara woman's hat is the bowler worn by the women of the Titicaca basin, but styles vary by region.

Communicate with the Family

Assess and treat the child in the context of his or her family, avoiding separation whenever possible. Emergency department policy should encourage parental accompaniment of children to the clinical area. It is optimal to consider that there are two patients, child and parent(s), each with expectations that must be addressed. Caregivers have essential historical information and, in the case of infants and toddlers, are physically necessary to the performance of a meaningful physical assessment. At all ages, children watch their parents for cues with respect to how to respond to the medical staff. Parents who understand and accept the sequence of events involved in emergency care become allies in enlisting their child's cooperation. Whenever possible, parents should be encouraged to remain present during procedures, maintaining visual and physical contact from a sitting position. Appropriate exceptions include parental discomfort and critical illness. Finally, because parents are...

Late Infancy 6 to 18 Months

NEUROLOGIC ASPECTS The normal infant sits with minimal support, transfers objects from hand to hand, and babbles by 6 months. By 9 months of age, the infant is crawling, pulling to a standing position, and verbalizing with nonspecific jargon. By 12 months, the infant has a mature pincer-type grasp, begins to walk, and acquires specific words. The developmental combination of mobility and grasp results in increasing risk of toxic and foreign-body ingestion. Between 9 and 12 months, a strong sense of stranger anxiety, related to fear of separation from parents, is acquired and complicates every aspect of physical assessment. Conversely, the failure of an older infant or toddler to recognize and preferentially respond to parents suggests significant disease. AGE-SPECIFIC APPROACH Assessment of an older infant and toddler begins with observation, preferably without the child's awareness of the examiner's presence. The child should be undressed to obtain a meaningful respiratory rate and...

Gender Roles in Economics

Husband and wife will often go foraging together once they get older, in their sixties. Even younger couples will forage together some during the honey season. The husband will look for honey while his wife is digging or gathering baobab nearby. The wife will take an infant with her, and sometimes even older children will accompany their parents. Toddlers are almost always left in camp because they are too young to walk far and too big to carry.

Sedation Agents And Techniques

Sedate children and should not be forgotten in the midst of a busy emergency department. As previously discussed, parental involvement, verbal preparation, relaxation, tactile stimulation, and distraction techniques are all effective. Manual restraint (sheets or papoose boards) may be required as an adjunct to the nonpharmacologic and pharmacologic approach to procedures for infants and toddlers. Parent should not be requested to provide or be responsible for the restraint of the child, but rather should be encouraged to provide comfort.

Radial Head Subluxation

For children who recover full, unrestricted use after one or two reduction maneuvers, further therapy is unnecessary. A sling may be offered to the child whose function and use have improved but are not complete. The toddler will often discard the sling within minutes or hours, however. Parents should be gently reminded to avoid lifting the child by the hand, wrist, or forearm and should be informed of the increased risk of recurrence until the child reaches 5 to 6 years of age.

Gender over the Life Cycle

A set of age categories for women describe different aspects of the life cycle but do not have the same corporate or political functions as those of the men. Babies and toddlers are not distinguished by gender but are simply called kyinibo or pede nyinibo ( those who fail to look after their own excrement ). Young children who are fully mobile are collectively referred to as wodo yudu or town children. Girls begin to have more household duties at this age, collecting wood and water and looking after younger siblings. Such tasks are not gender specific, however, since boys who have no sisters or who are simply available when the need arises will also be pressed into service.

Iron Nutrition Iron Deficiency

Iron deficiency is the most common of nutrient deficiencies, affecting as many as two-thirds of all children and women of child-bearing age worldwide. Iron deficiency severe enough to cause anemia affects 20-25 of infants and as many as 40 of women and 25 of men. Iron deficiency occurs in industrially developed as well as developing populations. In the United States, 9-11 of toddlers, adolescent girls, and women of child-bearing age have iron deficiency, and 2-4 have iron deficiency anemia. The prevalence of iron deficiency is approximately doubled in US black and Hispanic women.

Disorders Involving the Foreskin

Differentiation of the genitalia occurs between the ninth and thirteenth gestational week. The prepuce of the glans penis, which forms the foreskin, is adherent to the underlying glans penis and remains so throughout gestation and during the first several years of postnatal life. The foreskin of the newborn and infant cannot easily be retracted. Doing so shears the attachments between the epithelial layers of the glans penis and the foreskin. This normal adherence of the foreskin of the infant and toddler to the underlying glans penis is referred to as physiologic phimosis and is a part of normal male child physical development and maturation. It can persist in some (3 to 6 percent) boys into the grade-school years, spontaneously resolving during early puberty in the vast majority of boys.

Conceptual Development

During the toddler years, objects tend to be named at the so-called basic object level (e.g., dog or car) rather than at the subordinate (e.g., dalmatian and Mercedes) or superordinate (e.g. animal and vehicle) levels. Objects within the same category at the basic object level tend to share perceptual and functional features, and they do not overlap with related semantic categories. Thus, this level may be the most useful for children for both functional and cognitive reasons. Parents also have been shown to name objects for children at the basic object level and this too might explain why this is the preferred level for children's early words.

Curriculumbased Testing

A good example of a curriculum-based approach to assessment of preschool children is the Carolina Curriculum for Preschoolers with Special Needs (CCPSN Johnson-Martin, Attermeier, & Hacker, 1990), which is an upward extension of the program developed for infants and toddlers. Addressing the domains of gross motor, fine motor, cognitive, language, and social self-help, the authors devised items in the order that they should be taught, without attempting to represent developmental milestones or align the items with specific age levels. As is typical of curriculum-based approaches, the items included in the sequences were drawn from the clinical experience of the authors, the research literature, and a variety of published assessment instruments (p. 3). The authors acknowledge the inevitable overlapping of task demands among the domains and downplay the assignment of a skill to a particular domain. Therefore, it is important for assessors to be able to analyze the possible bases for item...

Children versus Adults

FRACTURE PATTERNS Fracture patterns relate to developmental anatomy. Young children have a higher incidence of frontal bone injury due to its prominence. Infants and toddlers almost never suffer midface fractures. The dearth of maxillary fractures under age 6 is due to the lack of sinuses in the midface. It is these sinuses that weaken the facial buttresses and predispose adults and adolescents to LeFort injury. As the child grows, the sinuses pneumatize, and fractures shift to the midface and lower face. By age 12 to 15, the fracture pattern resembles that in adults.

Empirical Studies

The troublesome behavior is maintained under an intermittent schedule. For instance, parents taking away a toddler's bottle may ignore requests for the bottle on many occasions, then give in to a midnight crying fit and provide a bottle just this one time so we can sleep. The result is that asking for the bottle has been reinforced under an intermittent schedule and, therefore, has become more resistant to extinction. The rate and pattern of responding in extinction is strongly influenced by how reinforcement was arranged prior to extinction. As a rule, the more intermittently reinforcement occurred prior to extinction, the longer behavior persists when extinction is arranged. Inconsistent use of extinction is apt to constitute an intermittent schedule that reduces the effectiveness of subsequent, consistently arranged, extinction. Effective clinicians recommend the use of extinction only when they are relatively sure that the procedure can be implemented consistently over long...

Just for Moms and Dads Being There for Your Adult Daughter

1 Remember that your child still cares about your opinion. If you think she's making huge mistakes in the way she's dealing with endometriosis, stay quiet unless the result is life threatening or she asks you what you think. When she does ask, be tactful. Talk to her like you talk to a friend, not a toddler.

Prevalence of Micronutrient Supplement

1999-2000 (post-DSHEA) indicate that 52 of U.S. adults were taking at least one dietary supplement. Supplement users were more likely to be toddlers and preschool-aged children and middle-aged and older adults. Across all age groups, vitamin mineral combinations and multivitamins were the most common types of supplements used by individuals who took only one supplement. Collection of these type of data is important to monitor use, identify usage trends, and help understand the popularity of micronutrient supplement use.

Individuals with Disabilities Education

In addition to mandating services for children over the age of 3, Part C of IDEA makes available services for children from birth up to age 3. Infant-toddler services within IDEA recognized the need to augment the development of children with disabilities, minimize the need for later special education via early intervention, capitalize on one's ability to live independently, and to improve the capacity of a family to meet the needs of their child.

Vitamins and Nutritional Supplements

For most nutritional supplements, there are few risks because what is not needed is excreted or metabolized. However, a number of vitamins and minerals carry significant risks of overdosage with well-described overdose syndromes. The fat-soluble vitamins (A, D, E, and K) tend to be stored in the body and can accumulate when administered in excessive doses. One of the B vitamins can induce a peripheral neuropathy in some individuals. Because nutritional supplements are treated like food products rather than like drugs from a regulatory standpoint, there are no quality control standards to assure consumers about the quantities and quality of a formula's constituents. There is no information or data about the safety of various combinations of supplements, about their interactions with other medications, about their effects on the developing nervous system of infants and toddlers, or about their long-term effects. Some formulae are expensive, costing up to 100 month, an expense...

Libby Kumin PhD Cccslp

Speech and language development is based on hearing language in the environment. Sensory inputs from auditory, visual, tactile, kinesthetic, and proprioceptive systems enable infants and toddlers to learn about the objects and people in their environment. The associative areas of the brain enable infants to make sense out of what they see and hear in the environment and to connect sounds and symbols with people, objects, and events. The most common risk factors that we see in infants and toddlers with Down syndrome that directly influence speech and language development are low muscle tone in the oral motor area, including the lips, tongue, and jaw (Kumin and Bahr, 1999), relative macroglossia (Desai, 1997), and otitis media with effusion (Roizen et al., 1992) resulting in fluctuating hearing loss. Because there is no one communication profile, there is no one treatment plan. Treatment should be individually designed to meet all of the communication needs of the child.

TABLE 1191 Common Causes of Pneumonia

INFANTS 1 TO 24 MONTHS During the first 2 years of life, viruses are the most common etiologic agent of pneumonia. RSV, parainfluenzavirus, influenzavirus, and adenovirus account for most lower respiratory tract infections, including pneumonia, in this age group. I2,,4,7 There are at least 14 other viral agents isolated in children with pneumonia, which include rhinoviruses, enteroviruses, coronavirus, measles, varicella, rubella, herpes simplex virus, and Epstein-Barr virus. 7812 Bacterial pneumonia due to Streptococcus pneumoniae, Streptococcus pyogenes, Staphylococcus aureus, and H. influenzae should be considered in infants and toddlers who

Other Cross Sex Relationships

Another especially significant cross-sex relationship is that between grandchild and grandparent. These individuals normatively have a joking relationship that is especially pronounced in the case of a cross-sex pair. The joking is frequently insulting and or sexual, even for young children. In fact, babies sometimes learn their first words from their cross-sex grandparent who teaches the tot lewd insults that the baby is expected to repeat. You black testicles, You red vagina, and other such sexual insults are not infrequently a toddler's first mangled words, aimed with good effect at the opposite-sex grandparent, to the general delight of all present.

Obtain Meaningful Vital Signs

Eliciting an adverse reaction to the examiner (e.g., respiratory rate taken by observing abdominal movements, and heart rate auscultated through clothing). If fever is a concern, temperature should be obtained rectally in infants, toddlers, and uncooperative children, because the oral, axillary, and tympanic routes are less reliable. Temperature measured by the oral route is likely to be feasible and accurate in children by 4 to 5 years of age. Blood pressure should be measured on previously well children who are 5 years of age and older (school age), children with chronic disease associated with hypertension (e.g., renal disease), and all children who are critically ill. Weight is a pediatric vital sign because of dosing considerations and the importance of growth as an indicator of chronic disease in children. Appropriate scales and growth charts should be available in emergency departments. For resuscitation purposes, bedside estimates of weight are frequently inaccurate, and...

Dietary Interventions

Nutritional strategies beyond the toddler years focus on avoidance of obesity. A number of studies have evaluated the caloric requirements for individuals with PWS. Weight maintenance has been reported with intakes of 8-11 kcal cm day (non-PWS children require 11-14 kcal cm day) weight loss has been documented with intakes of 7 kcal cm day. Proper implementation of caloric restrictions requires

Acquired anorectal disorders

Anal fissure is the most common cause of minor rectal bleeding in infants and toddlers, and is associated with constipation and painful defaecation. The tear in the anal mucosa is typically located in the posterior midline. Chronic fissure is sometimes associated with a sentinel skin tag at 12 o'clock position. Treatment consists of stool softener, sitz bath and local anaesthetic gel application. Occasionally a chronic fissure requires topical nitroglycerin therapy or lateral

Symptom Profile And Neural Bases A Social Abnormalities 1 Characteristics

Indicators of social abnormalities are noted early in autism, quite often as early as the first few months of life. Parents often remark that as infants, their autistic children stiffened when held, failed to make prolonged eye contact, and did not cry for help or consolation. A robust early indicator of social abnormality is a near absence of joint attention, or the coordination of attention between object and person, a skill that emerges in normal infants toward the end of the first year of life. As a category, joint attention behaviors may include pointing and showing objects and the use of eye contact and direction of visual gaze to and from an object and person. Normal infants and toddlers use such gestures regularly. Autistic infants and toddlers, on the other hand, rarely use such gestures and, given that joint attention is considered a precursor to normal language development, it is not surprising that this deficit compounds into not only later deficits in social behavior but...

Early Intervention Services Part C of the IDEA

Part C, formerly Part H, was added to IDEA in 1986 to expand access to early intervention family services for children with disabilities from birth to 3 years of age. Children 3 and older are served under Part B of IDEA. Part C was designed to provide coordinated service delivery to infants, toddlers, and their families and to fill gaps in existing services as needed. Many infants and toddlers can benefit from assistive technology to develop communication, perceptual and fine motor skills, as well as improved mobility. Assessments are critical in selecting appropriate technology and should be conducted by qualified professionals as part of a developmental assessment team. It is particularly important to recognize that infants and young children are developing quickly and their needs may change rapidly. Assessments should be considered an ongoing process. The assistive technology assessment should consider the following

Socialization of Boys and Girls

Mothers make little fuss over toilet training, encouraging toddlers to go outside in the lane to eliminate, and cleaning up any mess the children make in the house. Training in table manners begins by age 2 or 3. Children are instructed to dip their fingers into the communal bowl of stew only to the first knuckle, for to dig in deeper shows greed. Little children are also sent to take a bit of the food and put it outside the door before the family eats, so the spirit beings can consume the essence of the food while humans are eating the substance. Both genders and all ages eat together. Girls and boys differ somewhat in their play pattern. Groups of little girls, sometimes with toddler brothers in tow, play house, using stones to demarcate houses and sheep corrals, and animal bones of different sizes to represent humans and animals. The dusty lanes between the family houses become their playground. As soon as boys are fairly mobile, they join other groups of boys in rough-and-tumble...

The role of carers in flavour learning by the child

The Department of Human Development and Family Studies at The Pennsylvania State University have shown another interesting consequence of bottle feeding on later food consumption (Fisher, Birch et al. 2000). In this case comparisons were made between toddlers which had either been breast fed or bottle fed earlier in life. One of the main conclusions of this work was that breast feeding in the first year showed benefits on food intake and feeding style which persisted into the toddler phase. However, a noteworthy aspect of this work was the conclusion that these benefits were indirectly derived from the mother-child relationship that developed during breast feeding and that this had more to do with the behaviour of the mother than the child those who breast fed their babies could not see how much milk they provided and they developed a relaxed attitude to the fact that their infant was getting enough to eat, the mothers who bottle fed their children were able to see how much the babies...

Nonpharmacologic Modalities

Are best suited for infants, toddlers, preschoolers, school-age children, and adolescents. Physical techniques include kinesthetic or tactile stimulation, heat and cold applications and massage as well as the more complex modalities of transcutaneous electrical nerve stimulator (TENS), acupuncture, acupressure and electro-acupressure.

Childrens Behavior Nurturance Dependency Prosocial Acts and Aggression

Nurturance can be defined as offering help and support to an individual who is in a state of need. Although there are variations in the styles and situations in which it is expected to express nurturance, it is a recognizable universal across culture. With age, children are more capable of perceiving, understanding, and meeting others' needs and wants, and then responding to them. For example, they learn how to offer food to distract a crying toddler or how to encourage a friend with a smile. In almost all societies, infants and toddlers receive higher proportions of nurturance than do older children because of their relative helplessness and vulnerability as well as their cute and endearing physical characteristics (Braten, 1996 Edwards, 1986, 1993 Whiting & Edwards, 1988). Infant crying seems to elicit nurturance behavior from even very young children (Zahn-Waxler, Friedman, & Cummings, 1983). When infants grow older and become more mobile, independent, and demanding, they still...

Twenty First Century Adoption Practices

By the beginning of the twenty-first century, private and public adoption agencies served different communities. The private agency or practitioner deals primarily with Caucasian infants born in the United States and with international adoptions of infants and toddlers. Public agencies, connected to the welfare system, place special-needs children. These children are usually older, part of a sibling group, non-Caucasian, racially mixed, or with medical or developmental problems. The federal government has enacted special programs, with financial incentives to local public agencies, to increase the numbers of children moving from foster home placement into permanent or adoptive homes. In both public and private agencies, there is greater acceptance of adoptions by single persons and gay and lesbian couples.


Aggression is common among neurologically normal individuals and in diverse populations of brain-injured individuals. Homicide is the second most common cause of death among young adults and the 12th leading cause of death at any age in the United States. One population-based survey suggested that 3 of individuals commit violent acts annually, with a lifetime prevalence of 24 . However, other studies suggest that 94 of parents in the United States physically punish their toddlers, 11-17 of husbands physically hit their wives, and 11 of wives physically hit their husbands. Up to 40 of individuals admitted to psychiatric wards of general hospitals are violent immediately before admission, and up to 37 assault staff or patients during their hospitalization. Relatives of individuals with traumatic brain injury identify temper and irritability as major behavioral difficulties in 70 of patients. Imprisoned criminals evidence schizophrenia, major depression, and manic-depressive disorder at...

Pain Assessment

Well-validated pain assessment tools are available. 3 Tools specific to an age group or developmental stage should be selected. Children who are developmentally delayed, emotionally disturbed, or non-English speaking require special assessment. Pain severity in infants must be inferred from physiologic and behavioral responses, but for the toddler and older child, subjective measures can be included. Parental involvement in pain assessment can be a valuable adjunct for relieving pain and anxiety.4 Finally, pain measurement should be repeated and improvement assessed until pain has abated.

Blunt Trauma

Lower extremity fractures are often associated with intentional injuries in children. In fact, child abuse accounts for 20 of pediatric femoral fractures. Each year, more than 1200 children in the United States die from child abuse. The failure of a primary care physician to diagnose child abuse in a patient increases the child's risk for further abuse and violent death for the forensic pathologist, failure to diagnose child abuse on postmortem examination increases the risk that other children in the household will end up on the autopsy table. Therefore, the diagnosis of intentional injury should always be considered when a toddler presents with a lower extremity fracture.

Clavicle Fracture

Clavicle fractures may occur in the newborn as a result of shoulder compression during a difficult delivery. In the older infant, toddler, or child, the usual mechanism of fracture is a fall onto an outstretched hand or elbow or onto the side of a shoulder. Often, in younger children, the fracture is of the incomplete, or greenstick, type. A direct blow to the clavicle may also cause a fracture.

Thermal Injuries

Nevertheless, scald injuries to the lower extremity can be unintentional. In a series of three patients, all thought to be victims of child abuse, investigators discovered (on careful multidisciplinary investigation) that their injuries were owing to unintentional injuries occurring as a result of climbing into hot, water-filled sinks. In each case, a toddler used the toilet seat or a stool to climb into the sink and gain access the hot water supply (20). Nevertheless, any toddler with a significant lower extremity scald, especially when combined with other injuries, is likely to have been intentionally injured. A thorough examination for other injuries (which may involve the use of a radiological skeletal survey, a computed tomography scan of the brain, and a retinal examination) should be considered in such cases.

Groups at Risk

At home, swimming pools and bathtubs are hazardous settings for infants (see Subheading 13.1. and refs. 11, 13, 29, 38-40, 53-56, and 58-60). Children less than 1 yr of age are at risk for bathtub drowning infants older than 1 yr have a higher risk of drowning in a pool. Children are at higher risk of drowning in inground pools compared with aboveground pools (61 ). The highest risk in young children is within the first 6 mo after a pool is installed (62). Toddlers may be simply playing near the pool edge rather than wading (12,39,55,57,63). A similar scenario is seen with infants playing near the surf at a beach (46,64). Stepping onto solar pool blankets is a potential hazard for children (48). Some studies have noted a high incidence of drowning in 5-gal buckets ( Toddlers, because of a high center of gravity, are prone to falling into buckets (53.70). The at-risk age is 8 to 15 mo (71). In most cases, the buckets involved have been used for general cleaning or for...


A common result of normal activity in young children as they first learn to walk. The same fracture in a nonambulatory infant or child indicates probable child abuse. Fig. 52. Toddler's fracture. A common result of normal activity in young children as they first learn to walk. The same fracture in a nonambulatory infant or child indicates probable child abuse.

Targeted Behaviors

Among persons who are typically developing, backward chaining has been effective in treating children with specific speech problems such as misarticulation. In 1987, Edna Carter Young used backward chaining as part of a procedure to retrain the speech of two toddlers who frequently omitted weak syllables or consonants. Essentially, the procedure involved teaching the child to say the last part of a word first and then incorporating that part into the word. For example, to learn to say the word monkey, the child was first taught to say key, and then join it to the rest of the word, mon, thereby producing the word monkey.

Childhood Onset

As toddlers and preschoolers the children psychoanalytic theory destined for manic-depressive illness often are described as highly creative, bright, verbal, and intellectually ahead of most other children. Parallel to these positive developmental factors parents also recall that their children experienced severe separation anxiety and night terrors much longer than most youths. Additionally, many children who are developing manic-depressive illness have vivid, explicit dreams that typically focus on violent themes filled with blood and gore. This type of color-filled descriptive violence can also occur in the discourse of normal conversations. They may meet simple requests or instructive guidelines, such as gently requesting the child to remain in line, with an exaggerated physical threat. A parental no can send the manic-depressive child into a destructive rage for hours. During tantrums these children routinely cry, kick, hit, pull hair, bite, and attempt to punch holes in the wall...


The following suggestions can also protect the baby or toddler 6. Fireguards, playpens, and stair gates will protect your toddler from dangers in the home should you have a seizure and be unable to supervise the child. 7. Consider attaching toddler reins to your wrist until your child understands the importance of staying near you in the event you have a seizure. Let your family and friends know if you need help in caring for your new baby or toddler. You can also contact local community services, including those specializing in services for people with epilepsy.

Patient Factors

Diagnostician from making a diagnosis when the behaviors that have been identified can be better explained by developmental factors. For example, the term rebellious adolescent is as redundant as dependent toddler. In fact, behavior contrary to these developmental processes would be questionable. By taking a developmental perspective the therapist can easily craft interventions that will have a higher likelihood of working.


Temperament refers to the relatively stable mood and behavioral profiles that are observed in childhood and believed to be at least partially genetically based (Schwartz, Snidman, & Kagan, 1999). Behavioral inhibition is a temperamental style described by Kagan and colleagues as a shy demeanor and tendency to approach novel situations with restraint, avoidance, and distress. Some research has found that behaviorally inhibited children have an increased risk of anxiety disorders, especially SAD. In addition, Schwartz et al. (1999) found that 61 of adolescents who were inhibited as toddlers had current social anxiety, compared to 27 of those who were uninhibited as toddlers.

Child Abuse

Butterfly Fracture Direction

Another leg injury considered diagnostic of abuse is fractures of the shafts of the femur or tibia (44,49). These injuries can be spiral or oblique as the bone is twisted or, more commonly, transverse as the bone is bent (39,47,48) and are found four times more frequently than epiphyseal fractures. Worlock and associates (37) noted that infants tended to suffer leg fractures to a greater extent than toddlers. This suggests that infants are more prone to being lifted by the legs and that the risk decreases as the child becomes heavier and more awkward to lift with age.


Once soda pop was the exception rather than the rule when it came to choosing a beverage. Now, it is virtually the default beverage for adults and children alike. In fact, some studies indicate that soda pop may provide up to 20 percent of teens' calories each day. In addition, up to 20 percent of toddlers drink soda pop.


It is of special importance to note the increased vulnerability of children and the elderly to heat-related illnesses. Children produce more heat from metabolism per kg of body weight than adults, and, because their total body mass is smaller, their core temperature can change very rapidly. Infants and toddlers are also unable to regulate their own fluid intake and they may become rapidly dehydrated in a hot environment. Elderly individuals often have an impaired thirst response to dehydration and or may be subject to medical conditions


Intake' of 400-500 mg RAE has been set as a guide for infants in their first year, making infant VA intakes from breast milk marginal and, beyond infancy, marginally above an estimated deficient threshold thereafter (i.e., 210 mg RAE). Decrements in intake or concentration below this minimum increasingly place breast-fed children at risk, with greatest risk for those fully weaned and lacking a nutritious home diet. Studies in Asia and Africa show that breast-fed infants and toddlers are 65-90 less likely to have or develop xerophthalmia than non-breast-fed peers of the same age. Xe-rophthalmic children have been shown to begin weaning earlier (by month) and to be weaned 6 months earlier than nonxerophthalmic children. Even when breast-fed, the more frequent the daily feeds, the greater the reduction in risk of xerophthal-mia, reflecting the potential benefit achieved by promoting breast-feeding. However, the nutritional margin is still evident in the protective effects of vitamin A in...

Twisting Injuries

Twisting injuries create spiral fractures in long bones, highly specific for child abuse in children who are not yet ambulatory. Spiral fractures in ambulatory children lose their specificity for child abuse but remain a potential manifestation of abuse and warrant careful consideration. Whereas toddlers (1 to 3 years of age) commonly suffer spiral fractures of the lower one-third of the tibia accidentally as the result of a trivial fall or by twisting themselves on a planted foot (the so-called toddler's fracture), spiral fractures of the tibia may occur with child abuse. Spiral fractures of the femur may be accidental in toddlers but can also be seen in child abuse in this age group. Spiral femur fractures in newborns and preambulatory infants are highly suggestive of nonaccidental trauma. Correlation with the alleged mechanism of injury and a discrete but careful inspection for other evidence of abuse will prove helpful, along with a review of past injuries experienced by the child...

Followup Studies

Indeed, the Zahn-Waxler et al. study 9 , which found that offspring of a bipolar parent showed a range of adjustment problems as infants and toddlers, which continued four years later - including some that could be classified as DSM-III psychiatric disorders - represents a further extension of the same perspective, according to which relatively amorphous mood instability in the children of bipolar mothers crystallizes over time into more recognizable affective disorder.

Physical Abuse

Toddlers and older children should be questioned about the circumstances of the injury, and the comments should be recorded verbatim on the record. These statements are frequently admissible in court under exceptions to the hearsay rule and may help establish the diagnosis of child abuse. The physical examination should note the child's overall hygiene and well-being. Normal children, especially toddlers who are just learning how to walk, may have multiple ecchymoses over the anterior shins, the forehead, and other bony prominences. Most falls result in bruises on only one body surface. Bruises over multiple areas, especially the low back, buttocks, thighs, cheeks, ear pinnae, neck, ankles, wrists, corners of the mouth, and lips suggest physical abuse. Handprints may be observed, or there may be uniform but bizarre bruises caused by belts, buckles, cords, or blunt instruments. 30 Bites produce bruising in a characteristic oval pattern, with teeth indentations along the periphery....


Spinrad Nancy Eisenberg and Richard Fabes conducted a meta-analysis on age changes and children's prosocial behaviours (Eisenberg & Fabes 1998). They found prosocial behaviour increases with age in general, but these vary by the context of the studies and with the age range. There are fewer studies in infancy and toddlerhood however, Zahn-Waxler and her colleagues have some evidence that prosocial behaviour does increase in toddlerhood (Zahn-Waxler & Radke-Yarrow 1982, Zahn-Waxler et al 1992, 2001), as do some others (Van der Mark et al 2002, Lamb & Zekhireh 1997). In general, we see increases in prosocial behaviour with age, but the strength of these findings varies depending on the context and the methods used (Eisenberg & Fabes 1998). Spinrad There is an interesting study by Robinson et al (2001). Using a twin-design sample, the researchers examined toddlers' responses to feigned distress in several situations, when the victim was either a stranger or the mother. Their findings...


Diagnostic tools with toddlers suspected of having autism, such as the PL-ADOS, for the first time allows researchers not only the ability to obtain information at young ages in the disorder but also, the opportunity for longitudinal investigations of behavioral and neurobiological growth and development, beginning at a period when brain development in autism is not only quite active but also undiscovered.

Clinical History

Infants with PWS exhibit decreased fetal movement, weak cry, neonatal hypotonia, genital hypoplasia (cryptorchidism and clitoral hypoplasia), and failure to thrive (due to hypotonia and poor feeding). Toddlers with PWS acquire major motor milestones later than controls (walk at 24 months). Hyperphagia becomes evident between 18 months and 7 years of age. The majority of patients with PWS have growth hormone deficiency with short stature manifest during childhood and lack of a pubertal growth spurt. Individuals with PWS have an elevated pain threshold and vomiting threshold, with reports of delayed diagnoses of fractures, appendicitis, and gastroenteritis with significant morbidity. Obesity-related comorbid-ities, including sleep apnea, diabetes, and cor pulmo-nale, will shorten life expectancy without aggressive interventions. Behavioral problems, including obsessive-compulsive behavior (skin picking and rectal digging), stubbornness, and food foraging (including garbage and frozen...

Auditory Skills

Children with Down syndrome are at increased risk for hearing loss. It is essential to have the pediatrician and the audiologist monitor hearing on a regular basis and treat any hearing problems (Cohen et al., 1999, Roizen et al., 1994, Shott, 2000). Some kinds of tests can be used to test infants within the first week of life. Otitis media with effusion (OME), inflammation of the middle ear with fluid buildup behind the eardrum, is the most common problem related to hearing. The fluid interferes with sound transmission, and the result is a conductive hearing loss that is fluctuating. It is difficult for infants and toddlers to learn to listen and to attend to sounds when they sometimes can hear the sounds and other times cannot (Roberts and Medley, 1995).

Provocation Tests

Problems with capsules Capsules are unsuitable for use in children who cannot swallow large capsules, and this is a major limitation as most cases of suspected food allergy are in infants and toddlers. Furthermore, it is unsatisfactory to allow patients or parents to break open capsules and mix the contents with food or drink, as the color (e.g., tartrazine) or

Assessment Of Play

Sets in order to provide sufficient opportunity to observe the child's repertory. Observations are of both independent and facilitated play, and the assessor scores the occurrence of all play behaviors offered by the child, resulting in calculation of a developmental age. The PAS has been included in a number of research studies establishing its high level of concurrent and predictive validity, as well as interscorer reliability (e.g., Eisert & Lamorey, 1996 Fewell, Ogura, Notari-Syverson, & Wheeden, 1997 Harrison & Kielhofner, 1986). Although it is appropriate for infants and toddlers, it is mentioned here because the functioning of many of our referred children falls within these age ranges, and it is helpful for the assessor to have a sense of the full developmental sequence of play behaviors.

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