Infants depend on caregivers, usually parents, for basic needs such as food. Infants learn to trust others based upon how well caregivers meet their needs.

• Trust: When caregivers respond promptly to an infant’s cries, the baby can learn to rely on others. As caregivers fill an infant’s needs, the baby can develop a sense of trust and security. 

• Mistrust: If caregivers neglect an infants’ needs, or if care is sporadic, an infant may grow insecure. They may learn they cannot rely on others and thus feel unsafe.

During this phase, toddlers begin exploring the world around them. They learn more about their environment and their place within it. They also develop basic skills such as toilet training.

• Autonomy: Autonomy simply means that we recognize ourselves as being separate individuals. In their progress through infancy, toddlers learnt to rely on their parents or primary caregivers. Now they begin to realize that they're their own person, one who's separate from their parents or primary caregiver. Autonomy is about independence. 

• Shame: Children whose caregivers discourage them may develop feelings of shame. If caregivers foster excessive dependence, the child may learn to doubt their own abilities.

Children in this stage may experience volatile mood changes. They can be very HAPPY, or very SAD, or very ANGRY.  Everything they do emotionally is over the top, due  to their lack of vocabulary to express their feelings and lack of self-control.

So when you ask a toddler a yes-or-no question, the response is very likely to be "No!" because they're learning that they have a voice. This is related to establishing autonomy. When you communicate with toddlers, you have to be careful to offer reasonable options beyond yes or no.

Let's say you need to give a toddler a medication. When you enter the room, you may be tempted to say something like, "Can you take this medicine for me?" The toddler will most likely respond with "No!" You need to rephrase the statement to give the toddler an option, which allows him or her to maintain a sense of control over the situation. A better way to approach the task would be to say, "I have your medication. Do you want to take it for me or for mommy?" This offers the toddler a sense of control by giving him or her a choice, which fosters autonomy.

Regression 

One major issue affecting toddlers is a concept called regression. Children regress in their development when faced with stressful events such as hospitalization. When a child regresses, he or she falls back psychologically to an earlier stage of growth and development where he or she felt safe. This defense mechanism helps protect the child's psychological well-being. 

Nurses should encourage parents to be empathetic with children when regression occurs. Shaming a child because of regression, such as saying "Don't be a baby," is never the right approach. Instead, offer gentle encouragement to support the positive aspect of the child's developmental stage. 

Preschoolers are increasingly focused on doing things themselves and establishing their own goals.

• Initiative: When caregivers nurture these tendencies, children learn how to make decisions and plan for the future. Giving them  an opportunity to initiate their own care by performing a task such as brushing.  This can encourage initiative.   

• Guilt: If children are criticized for being assertive, they may feel guilt for pursuing their desires. Controlling caregivers may teach children to follow another’s lead rather than starting their own plans.

Preschoolers can experience real or imagined fears, which can manifest as a psychosocial issue. For example, preschoolers may believe that inanimate objects have thoughts and feelings. Have you ever seen a child bump her head on something and then get mad at the object? This is called animism-the belief that inanimate objects have a spirit or soul. The child believes this object hurt her, so she's angry with it.

When a preschooler plays dress-up, she believes she's really the person she's dressed up to be. Because of their propensity toward magical thinking and their tendency to think in literal terms, preschool children need to have things explained very clearly. However, you must remember to use terms that are nonthreatening-a fear of body mutilation is another characteristic of this developmental stage.

If nurses place an I.V., for example, the child may think we've placed an object that will now be with him or her forever. We've changed the arm, and the I.V. is now an extension of the child. So take care to explain how the I.V. works in simple terms. For examples, you can tell them that that their arm is thirsty and the I.V. is a drinking straw their arm will use to take a drink.  

Because of their inability to truly understand cause and effect, preschoolers also have a tendency to view painful procedures as a punishment for bad behavior. Reassure them that they haven't done anything wrong, but that they're sick and need to have the procedure to make them better. Rewards like stickers are good to use for positive reinforcement and praising preschoolers helps, too. 

As children grow independent, they become increasingly aware of themselves as individuals. They begin to compare themselves with others.

• Industry: Children who are accomplished compared to their peers can develop self-confidence and pride. Praise for their achievements can boost their self-esteem.

• Inferiority: Children who do not achieve certain milestones may doubt their abilities or self-worth. When children are constantly criticized, they may develop feelings of inferiority.

School-age children often think in concrete terms, so when teaching them about self-care, communicate in a way that encourages learning through a hands-on approach. Letting the child use medical equipment on a doll or manikin is a good adjunct to patient teaching about his or her care or disease process.

Two of the most common diseases in school-age children are diabetes and asthma; both of these require self-maintenance, and children at this stage need to participate in their own care. Let's consider, for example, a school-age girl with asthma. She needs to know what triggers her asthma so she can avoid those triggers during her school day. She also needs to be able to recognize when she's having an exacerbation of her asthma so she can ask for or self-administer her rescue inhaler. With proper education and support, she'll play an important role in maintaining her level of wellness.