Study topic
Paediatric growth and safety
NCLEX pediatric development chapter: milestones by age, Erikson tasks, play types, separation anxiety, and infant-toddler safety including car seats.
Pediatric development items ask whether you know what is expected at an age, which psychosocial task is in play, and how to keep a curious infant or toddler alive long enough to grow into the next stage.
Milestones worth memorizing
| Rough age | Expect |
|---|---|
| 2–3 months | Social smile; lifts head when prone |
| 6–8 months | Sits without support; stranger anxiety rising |
| 9–10 months | Crawls/cruises patterns; pincer developing; object permanence |
| 12 months | First steps for many; mama/dada with meaning; waves/bye |
| Preschool | Magical thinking, why questions, more associative play |
| School-age | Rules, skills, school competence |
Expected vs referral: a soft delay needs context, but missing major motor or language anchors (no sitting well into later infancy, no words near the first birthday cluster, loss of skills) prompts evaluation.
Erikson (and the theory items that hitchhike)
| Age band | Erikson task | Hospital / nursing support |
|---|---|---|
| Infant | Trust vs mistrust | Consistent caregivers, prompt needs, parent presence |
| Toddler | Autonomy vs shame/doubt | Choices within limits; expect “no” |
| Preschool | Initiative vs guilt | Play, simple explanations, medical play |
| School-age | Industry vs inferiority | Schoolwork, skill praise, routines |
| Adolescent | Identity vs role confusion | Privacy, peers, honest inclusion in plans |
Freud psychosexual (when the stem asks)
School-age children are classically in the latency stage on exam maps. Match the age band the stem gives; do not overthink Freudian detail beyond the standard NCLEX pairing.
Play, safety, and separation
| Play type | Picture |
|---|---|
| Solitary | Infant/young toddler plays alone |
| Parallel | Toddlers side by side, separate toys |
| Associative | Preschoolers share activity with loose organization |
| Cooperative | Older preschool/school-age organized toward a goal |
- 10-month safety priority teaching often centers on choking, falls, and car-seat use.
- Toddler homes need gates, locked meds/cleaners, water supervision, and outlet covers.
- Safe sleep teaching still matters alongside play safety: back to sleep, firm surface, no loose bedding.
Safety
Separation protest in a hospitalized toddler is expected. Support parent rooming-in when possible. Quiet withdrawal after long separation is despair, not “good settling.”
Priority map
| Picture | First move |
|---|---|
| Age + milestone question | Match the classic age band before inventing |
| Toddler saying no constantly | Autonomy task — offer safe choices |
| Two toddlers, separate toys | Parallel play — expected |
| Infant car travel teaching | Rear-facing in back seat per current guidance taught |
| Hospitalized school-age child | Protect industry: school and competence |
Must know
- 1Sit without support: typically around 6–8 months. Walk alone and first words cluster near 12 months. Missed key milestones need referral evaluation.
- 2Erikson: infant trust vs mistrust; toddler autonomy vs shame/doubt; preschool initiative vs guilt; school-age industry vs inferiority; adolescent identity vs role confusion.
- 3Toddler play is often parallel (side by side, not together). Preschoolers move toward associative/cooperative play.
- 4Separation anxiety in hospitalized toddlers: protest (cry/cling), despair (withdrawn), then detachment if prolonged. Support parent presence.
- 5Infant safety: rear-facing car seat in the back seat, supervise, avoid small choking objects, sleep safe (back to sleep, firm surface).
- 6Toddler safety: gates, locked cabinets, water watch, poison control awareness, car seat still rear- or forward-facing per size/age rules taught.
- 7Hospitalization support: school-age needs schoolwork/competence; adolescent needs privacy and peer connection; preschool needs play and clear simple explanations.
- 8Freud latency (school-age) is a common theory match item; do not invent ages outside the classic map.
Memory hooks
Trust → autonomy → initiative → industry → identity
Erikson from infant through adolescent in that order. Match the hospital support to the struggle.
Parallel = side by side
Two toddlers with separate toys near each other is parallel play, not failure to socialize.
Protest, despair, detach
Separation response in young children often moves from loud clinging to quiet withdrawal if parents stay away too long.
How it's tested
Stems ask the age for sitting alone, name the Erikson stage for a “no”-saying toddler, identify parallel play, or pick a safe 9-month toy and car-seat position. Distractors put a toddler in cooperative team sports play or treat protest crying as pathologic only.