1. Toddler (1-3 years)
    1. Erikson’s theory of personality development
      1. Central task: autonomy vs. shame and doubt; central persons: parents
      2. Behavioral indicators
        1. Does not separate easily from parents.
        2. Negativistic.
        3. Prefers rituals and routine activities.
        4. Active physical explorer of environment.
        5. Begins attempts at self-assertion.
        6. Easily frustrated by limits.
        7. Temper tantrums.
        8. May have favorite “security object.”
        9. Uses “mine” for everything - does not understand concept of sharing.
      3. Parental guidance/teaching
        1. Avoid periods of prolonged separation if possible.
        2. Avoid constantly saying “no” to toddler.
        3. Avoid “yes/no” questions.
        4. Stress that child may use “no” even when he or she means “yes.”
        5. Establish and maintain rituals, e.g., toilet training, going to sleep.
        6. Offer opportunities for play, with supervision.
        7. Allow child to feed self.
        8. Offer only allowable choices.
        9. Best method to handle temper tantrums: ignore them.
        10. Keep security object with child, if so desired.
        11. Do not force toddler “to share.”

      4. Physical growth (by 3 years)
        1. Height
          1. Slow, steady growth at 2-4 inches per year, mainly in legs rather than trunk.
          2. Adult height is roughly twice child’s height at 2 years of age.
        2. Weight
          1. Slow, steady growth at 4-6 Ib/year.
          2. Birth weight quadruples by 2.5 years of age.
        3. Vital signs
        4. Cardiac system
          1. Heart begins to function more efficiently.
          2. Decreased heart rate, slight increase in blood pressure from infant values.
        5. Pulmonary system
          1. Mainly abdominal breathing.
          2. Lumina of bronchial vessels in size —> decrease in lower respiratory system infections.
          3. Decreased respiratory rate from infant values.
        6. Gastrointestinal system
          1. Increased capacity —> three meals a day feeding schedule.
          2. Gastric juices increase in acidity —> decrease in GI infections.
          3. Possible voluntary control of anal sphincter.
        7. Genitourinary system
          1. Bladder capacity increases; to determine bladder capacity in ounces, add 2 to the child’s age (e.g., 2-year-old has a bladder capacity of 4 oz or 120 mL).
          2. Ability to “hold” urine increases.
          3. Possible voluntary control of urethral sphincter.
        8. Immune system
          1. Possible immunity from intrauterine life/maternal transfer disappears.
          2. Gradual increase in IgA, IgD, and IgE antibodies.
        9. Neurological system
          1. Anterior fontanel closed by 18 months.
          2. Brain increases to 90% of adult size.
          3. Progressive increase in intelligence.
          4. Myelinization of spinal cord is complete.
        10. Sensory system
          1. Hearing evidences basic auditory skills.
          2. Vision shows evidence of convergence and accommodation; full binocular vision developed; visual acuity: 20/40.
        11. Teething
          1. Introduce tooth brushing as a “ritual.”
          2. By 30 months: all 20 primary teeth present.
          3. First dental checkup should be between 12 and 18 months.
        12. Musculoskeletal system
          1. Lordosis: abdomen protrudes.
          2. Walks like a duck: wide-based gait, side-to-side.