Toddler: Developing Autonomy and Sensorimotor to Preoperational Thought

          • Toddler: Developing Autonomy and Sensorimotor to Preoperational Thought
          • Use same approaches as for infant plus the following.
            • Egocentric Thought
              • Explain procedure in relation to what child will see, hear, taste, smell, and feel.
              • Emphasize those aspects of procedure that require cooperation (e.g., lying still).
              • Tell child it is okay to cry, yell, or use other means to express discomfort verbally.
              • Designate one health care provider to speak during procedure. Hearing more than one can be confusing to a child*
            • Negative Behavior
              • Expect treatments to be resisted; child may try to run away.
              • Use firm, direct approach.
              • Ignore temper tantrums.
              • Use distraction techniques (e.g., singing a song with child).
              • Restrain adequately.
            • Animism
              • Keep frightening objects out of view (young children believe objects have lifelike qualities and can harm them).
            • Limited Language Skills
              • Communicate using gestures or demonstrations.
              • Use a few simple terms familiar to child.
              • Give child one direction at a time (e.g., “Lie down” and then “Hold
              • my hand”).
              • Use small replicas of equipment; allow child to handle equipment.
              • Use play; demonstrate on doll but avoid child’s favorite doll because child may think doll is really “feeling” procedure.
              • Prepare parents separately to avoid child’s misinterpreting words.
            • Limited Concept of Time
              • Prepare child shortly or immediately before procedure.
              • Keep teaching sessions short (≈5 to 10 minutes).
              • Have preparations completed before involving child in procedure.
              • Have extra equipment nearby (e.g., alcohol swabs, new needle, adhesive bandages) to avoid delays.
              • Tell child when procedure is completed.
            • Striving for Independence
              • Allow choices whenever possible but realize that child may still be resistant and negative.
              • Allow child to participate in care and to help whenever possible (e.g., drink medicine from a cup, hold a dressing).


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