Providing Developmentally Based Care for Toddlers

Abstract

ediatric patients are not just small adults; each child is a unique individual. Even during the “terrible twos,” as many refer to the toddler years when children are actively engaged in learning about their world, however, similarities do exist in perioperative care based on the child’s developmental level. From a developmental perspective, toddlerhood lasts from a child’s first birthday to his or her third birthday. It is a time during which the child throws temper tantrums and demonstrates negativism, passionate exploration, and assertiveness. Parenting a toddler often is demanding and challenging. The prospect of a surgical procedure creates additional stress for the child as well as his or her family members, and this may exacerbate a toddler’s outbursts and hinder parental coping mechanisms. Developmental theories offered by Freud, Piaget, and Erikson can help provide a theoretical foundation for understanding children at each psycho social and cognitive level (Table 1). Nurses who understand these theories may be better equipped to provide holistic, family-centered care. Nurses also must be aware that all humans have the potential to regress developmentally when under stress. The developmental theories presented in this column are intended to help nurses care for patients at this stage of development; if a toddler does regress, developmental interventions that are appropriate for infants should be considered.