Developmental Issues in Toddlers

Developmental Issues in Toddlers
Application: Protocol for Diagnosis, Management, and Follow-Up Care of Growth and
Development and Psychosocial Issues
As pediatric patients grow from infancy to adolescence, there are many common growth and
development and psychosocial issues that may potentially present. As an advanced practice nurse
caring for these patients, you must be able to recognize red flags and select age-appropriate
assessment and treatment options. In this Assignment, you prepare for your role in clinical
settings as you design an age-specific protocol for the diagnosis, management, and follow-up
care for a common growth and development or psychosocial issue.

Developmental Issues in Toddlers

Nurses identify red flags in situations where children fail to meet the expected
developments. There are guidelines that allow nurses to determine whether children exhibit a
normal course of growth. In the toddler stage, for example, children are expected to exhibit
tendency to seek independence (MacLeod, 2013). Aspects of growth considered in identifying
red flags include gross and fine movements, communication, as well as emotional and social


interactions (Queensland Government, 2010, Pg. 1). The capabilities that children attain at
different stages allow for the evaluation of their growth pattern. Children may also exhibit traits
that could suggest abnormalities. Both failure to express certain traits and expression of
abnormal characteristics raise alarms termed as red flags.
Sleep disorders are possible developmental ailments that toddlers could express. Both
excessive and reduced sleeping during toddler stage could be developmental disorders (Patient,
2015). Toddlers should develop the circadian pattern if their growth is normal. Common sleep
abnormalities that toddlers express include difficulties in settling in beds, and unexpected waking
up at night (Stores, 2009, Pg. 83). Other disorders include sleep apnea, periodic limb motion, and
restless legs complex (Stores, 2009, Pg. 83). Epidemiological investigations show that
approximately 30% of children experienced sleep disorders. Research shows that toddlers could
have more of night-time waking compared to other age groups (Stores, 2009, Pg. 84). On the
other hand, older children could have more nightmares compared to toddlers (Stores, 2009, Pg.
84). Toddlers with other developmental complications such as psychosocial insufficiencies are
most affected by sleep disorders.
In assessing and diagnosing sleep disorders in toddlers, practitioners should obtain an
informative history, and then conduct physical examinations on their clients. In most cases,
evaluating toddlers on cognitive and developmental abnormalities is essential (Moturi & Avis,
2010, Pg. 24). Healthcare practitioners should differentiate normal sleeping from the abnormal
type. For instance, it could be appropriate for toddlers to take habitual naps while it would be
pathological for older children (Moturi & Avis, 2010, Pg. 24). Tools necessary in diagnosing
sleep abnormalities include polysomnography. The tool is of particular importance for the
assessment of obstructive apnea (Moturi & Avis, 2010, Pg. 24). It is advisable that healthcare


providers involve parents in the management of sleep disorders in toddlers. Parents, guardians
and other family members are likely to offer information that would enhance the understanding
the etiology of sleep abnormalities in toddlers (Moturi & Avis, 2010, Pg. 24). Parents can also
facilitate follow-ups, especially by recording patterns of sleep shown by their young ones. In
addition to finding use in follow-ups, sleep diaries also provide rich information that is important
to history collection (Moturi & Avis, 2010, Pg. 24). It is also advisable that practitioners screen
toddlers for sleep disorders other than the already established ones. It is common for other
abnormalities to accompany primary sleep abnormalities. For instance, cognitive impairment and
day-time drowsiness could accompany sleep apnea (Moturi & Avis, 2010, Pg. 24).
Culture influences the diagnoses of sleep complications in toddlers. For instance, some
cultures could encourage co-sleeping while others may not (Moturi & Avis, 2010, Pg. 24). The
occurrence of certain sleep trait could be normal in some cultural setups while the same could
call for complaints in other cultures. Lifestyles adopted through culture could also impact on
both assessment and management of sleep disorders. Practices such as watching the television
could certainly affect sleeping patterns in toddlers (Moturi & Avis, 2010, Pg. 24).


MacLeod, S. (2013). Erik Erickson. Simply Psychology.
Moturi, S. & Avis, K. (2010). Assessment and treatment of common pediatric sleep disorders.
Psychiatry (Edgemont), 7(6), 24-37.


Patient. (2015). Common behavioral problems in children.
Queensland Government. (2010). The red flag: early intervention referral guide for children 0-5
Stores, G. (2009). Aspects of sleep disorders in children and adolescents. Dialogues in Clinical
Neuroscience, 11(1), 81–90

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