Lower jaw trembling is noted constantly, even when not crying or
excited.
Response to loud sounds is absent or minimal.
Signs of Poor Parent–Child Bonding
Parent touches child minimally (i.e., only when feeding or providing care).
Minimal eye contact noted between parent and child (unless culture
related).
Possible signs of abuse noted: bruising, poor hygiene, malnourishment.
Infant older than 6 months of age shows minimal attachment to parent.
Potential Illness or Injury
Congenital conditions (see maternal-child text) may manifest through
developmental delays or distress.
Respiratory distress may be noted secondary to decreased surfactant or
as in later months due to airway obstruction, particularly due to foreign
body insertion.
Accidents and falls (after 4 months) may occur due to unanticipated
mobility and unsecured elevated surface or insufficient hold on body
part.
Infection risk factor due to immature immune system.
Hypothermia due to diminished temperature control.
Malnutrition secondary to poverty or failure to thrive.
CHAPTER 2/ Growth and Development^17
Chronological Developmental Stage or Defining Key Impact on
Age Range Theory Phase Characteristics Nursing Care
TABLE 2–1•Developmental Characteristics: Birth to 24 Months
Birth to 18
months
First year
Birth to 2 years
Sigmund Freud
Personality
Id, ego, superego
Psychoanalytical
Eric Erikson
Life-span stages
Psychoanalytical
Jean Piaget
Social/cognitive
Oral stage
Trust vs. mistrust
Sensorimotor
stage
Pleasure centers
on mouth
Dependence on
significant other
for comfort and
support to build
trust
Coordinates
sensory
experiences with
physical action
Encourage
self-feeding,
avoid foreign
object ingestion
Support bonding
and maintenance
of family
relationships
Plan tactile
experiences and
colorful materials,
to stimulate senses