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Chapters 10*, 12, 13, 15, & 16
Health Promotion of the
Infant AdolescentPR!"#$ %'
(arissa !molars)i R", (!"
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OBJECTIVES
On completion of this presentation, students
will be able to:
1.Discuss the dierent theories of growthand development.
2.Identify the maor biologic,psychosocial,cognitive, and social developments andmilestones during Infancy, !oddler,"reschooler, #chool$age, and %dolescent
stages.&."rovide anticipatory guidance to parentsregarding nutrition, parental concerns duringeach stage, dealing with stresses, sleep and
development problems and inury prevention.ALL ELSEVIER ITEMS AND DERIVED ITEMS 2013, 2009, MOSBY, INC., AN IMPRINT OF ELSEVIER INC. 2
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'rief (eview
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PSYCHOSOCIAL DEVELOPMENT THEORIES
)reud*s stages of psychose+ual development
Oralstage (birth to 1 r!"
%nalstage (1#$ rs!""hallicstage ($#% rs!"atencystage (%#1& rs!"-enitalstage (1' rs!"
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PSYCHOSOCIAL DEVELOPMENTTHEORIES
ri/ ri/son 0 stagesTrst )s! *istrst (birth to 1r"Trst +are,ts -or basi. ,ee/s
Ato,o* )s! sha*e a,/ /obt (1#$ 0o" Baa,.i,g i,/e+e,/e,.e 2ith ,.ertai,t
I,itiati)e )s! git ($#% 0o" Co,3/e,.e to tr ,e2 thi,gsI,/str )s! i,-eriorit (%#1& 0o"
Co,3/e,.e throgh tas4 *aster
I/e,tit )s! roe .o,-sio, (1' 0o" Se,se o- se-
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CO5NITIVE THEORIES
ean "iaget 0 four stages Se,sori*otor (birth to age &"
Pri*ar .og,itio, is throgh se,ses Preo+eratio,a (ages & to 6"
De)eo+*e,t o- *otor s4is Not .a+abe o- ogi.a thi,4i,g
Co,.rete o+eratio,a (ages 6 to 11" Logi. So)e .o,.rete +robe*s
7or*a o+eratio,a (ages 11 to 18" Abstra.t reaso,i,g A,ati.a
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CHAPTER 1:CHAPTER 1:
ealth "romotion of theealth "romotion of theInfant and )amilyInfant and )amily
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PROMOTING OPTIMUM GROWTH
AND DEVELOPMENT
'iologic development'iologic developmentCe+hao.a/aCe+hao.a/aPro>i*o/istaPro>i*o/ista
"roportional changes:"roportional changes:
5ai,5ai, ???????????? o,.es +er 2ee4o,.es +er 2ee4Dobe B@ b ageDobe B@ b age????????*o,ths*o,thsTri+e B@ b ageTri+e B@ b age??????????Height i,.reases bHeight i,.reases b??????????+er *o,th -or %+er *o,th -or %
*o,ths*o,ths5ro2th i, s+rts5ro2th i, s+rtsRa+i/ hea/ gro2thRa+i/ hea/ gro2th
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7INE MOTOR DEVELOPMENT7INE MOTOR DEVELOPMENT
-rasping obect:-rasping obect: 3333333333monthsmonths!ransfer obect between hands:!ransfer obect between hands:
33333333monthsmonths
"incer grasp:"incer grasp: 33333333monthsmonths(emove obects from(emove obects from
container:container: 333333monthsmonths
'uild tower of 2 bloc/s:'uild tower of 2 bloc/s:33333333monthsmonths
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MATURATION OF SYSTEMS
Respiratory
Cardioas!"#ar
He$atopoieti! !%a&'es
Di'estie pro!esses
I$$"&o#o'i!
T%er$ore'"#atio&
Re&a# ("&!tio&
Se&sory
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CRUDE PINCER GRASP
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GROSS MOTOR DEVELOPMENT
Head #a' i& (irst))))$o&t%s
Head !o&tro# at))))$o&t%s
Ro##i&' oer *(ro$ a+do$e& to +a!,- at
))))$o&t%s
Para!%"te re(#e. +y))))$o&t%s
Sit a#o&e +y)))$o&t%s
Moe (ro$ pro&e to sitti&' positio& +y))))
$o&t%s
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HEAD CONTROL
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HEAD CONTROL *CONT/D-
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SITTING
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LOCOMOTION
Cep%a#o!a"da# dire!tio& o( dee#op$e&t
I&!reased !oordi&atio& o( e.tre$ities at
))))$o&t%s
Cra0#i&' at)))))$o&t%s *"s"a##y
+a!,0ard-
Creepi&' at)))))$o&t%s
Wa#, 0it% assista&!e at)))$o&t%s
Wa#, a#o&e at))))$o&t%s
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LOCOMOTION
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COGNITIVE DEVELOPMENT
Pia'et
Se&sori$otor p%ase *si. sta'es1 +irt% to 23
$o&t%s-
Refle stae' %irth to 1 month
Primar7 circ8lar reactions' 1 to months!econdar7 circ8lar reactions' to months
Imitation
Pla7
AffectCoordination of secondar7 schema' to 12
months%einnin of intellect8al reasonin
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DEVELOPMENT OF 4ODY IMAGE
Co&!ept o( o+5e!t per$a&e&!e 4y e&d o( (irst year666 disti&!t
(ro$ t%e pare&ts
I&!reased i&terest i& i$a'e 4ody is "se("#
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O47ECT PERMANENCE
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SELF6IMAGE
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SOCIAL DEVELOPMENT
Atta!%$e&t
Rea!tie atta!%$e&t disorder
*RAD-
Separatio& a&.iety Stra&'er a&.iety
P#ay as a $a5or so!ia#i8i&' a'e&t
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ATTACHMENT
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LANGUAGE DEVELOPMENT
Cryi&' 9 :st er+a# !o$$"&i!atio&
Vo!a#i8atio&s +y ; 0ee,s
Coo1 '"r'#e1 #a"'% a#o"d at)))to)))$o&t%s
I$itate so"&ds a&d add !o&so&a&ts at < $o&t%s
Co$pre%e&d =No>? (o##o0 !o$$a&ds at @ to :$o&t%s
As!ri+e $ea&i&' to a 0ord at)))to)))$o&t%s
T%ree to (ie 0ords 0it% $ea&i&' +y a'e)))year
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TEMPERAMENT
I&(#"e&!es t%e type o( i&tera!tio& t%at o!!"rs
+et0ee& t%e !%i#d a&d pare&ts
May +e a((e!ted +y t%e e&iro&$e&t a&d
(a$i#y
Reised I&(a&t Te$pera$e&t B"estio&&aireAssists in determinin temperament
$esined for infants 7o8ner than ae months
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CONCERNS RELATED TO NORMAL
GROWTH AND DEVELOPMENT C%i#d6reari&' pra!ti!es re#ated to
te$pera$e&t
Separatio& a&d stra&'er (ear
C%i#d!are arra&'e$e&ts
Li$it setti&' a&d dis!ip#i&e
T%"$+ s"!,i&' a&d "se o( a pa!i(ier
Teet%i&'
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PROMOTING OPTIMUM HEALTH
DURING INFANCY
N"tritio&
4reast $i#, :st !%oi!e oy (or t%e (irst)))
$o&t%s o( #i(e
NO &eed (or additio&a# (#"ids i& t%e))))$o&t%s
NO %o&ey i& t%e)))))o( #i(e
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NUTRITION
I&trod"!tio& o( so#id (oods a(ter a'e
)))$o&t%s
inter9als of to 4 da7s
(a7 need fl8oride s8pplements
Fi&'er (oods at)))$o&t%s
Wea&i&' (ro$ +reast or +ott#e to !"p
a(ter : year
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SLEEP AND ACTIVITY
No!t"r&a# patter& o( @ to :: %o"rs +y
to 3 $o&t%s
Tota# dai#y s#eep : %o"rs
4a!, to S#eep !a$pai'&
S#eep pro+#e$s S#eepi&' arra&'e$e&ts
I&(a&t 0a#,ers
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DENTAL HEALTH
Aoida&!e o( ear#y !%i#d%ood !aries
C#ea&i&' +e'i&s 0%e& pri$ary teet% er"pt
First de&ta# isit at)))$o&t%s *er"ptio& o(
(irst teet%-
Water is pre(erred to toot%paste "&ti# a(tera'e)))years
F#"oride s"pp#e$e&ts
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I":;R PR+"#I."
%spiration of foreign obects%spiration of foreign obects
7oo/ ite*s< +a.i3ers< bab +o2/er7oo/ ite*s< +a.i3ers< bab +o2/er#uocation#uocation
Late> baoo,s< .rib haar/sLate> baoo,s< .rib haar/s
4otor vehicle inuries4otor vehicle inuries Car seats +!$;6Car seats +!$;6
)alls)alls"oisoning"oisoning
'urns'urns
DrowningDrowning
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Infant Health Promotion
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CHAPTER 1&CHAPTER 1&
HEALTH PROMOTION O7 THE TODDLER AND 7AMILYHEALTH PROMOTION O7 THE TODDLER AND 7AMILY
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PROMOTIN5 OPTIMMPROMOTIN5 OPTIMM
5RO@TH5RO@THAND DEVELOPMENTAND DEVELOPMENT !he terrible twos;!he terrible twos;
%ge 12$&5 months%ge 12$&5 months
Intense period of e+plorationIntense period of e+ploration
!emper tantrums!emper tantrums
#tubbornness occurs fre
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4IOLOGIC DEVELOPMENT
Wei'%t 'ai& s#o0s to 3 to ; po"&ds per year
4irt% 0ei'%t s%o"#d +e "adr"p#ed +y 2 years
Hei'%t i&!reases a+o"t i&!%es per year
Gro0t% is step#i,e rat%er t%a& #i&ear
Ad"#t %ei'%t is 2 ti$es t%e %ei'%t at a'e 2 years A&terior (o&ta&e# !#oses +y)))$o&t%s
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SENSORY CHANGES
Vis"a# a!"ity o( 23 is a!!epta+#e Dee#op$e&t o( %eari&'1 s$e##1 taste1 a&d to"!%
i&!reases
Uses a## se&ses to e.p#ore t%e e&iro&$e&t
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MATURATION OF SYSTEMS
Most p%ysio#o'i! syste$s are re#atie#y$at"re +y t%e e&d o( todd#er%ood
I&&er ear str"!t"res 6 s%ort a&d strai'%t
to&si#s 6 #ar'e
"pper respiratory tra!t i&(e!tio&s1 otitis $edia1
a&d to&si##itis are !o$$o&
Vo#"&tary !o&tro# o( e#i$i&atio&
!phincter control at ae==to==months
Ne"ro+e%aiora# or'a&i8atio& i$proes
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GROSS AND FINE MOTOR
DEVELOPMENTLo!o$otio&>al)s ?7 === months@ r8ns ?7 === monthsClim?s stairs ?7 ae ==7ears
Has i$proed !oordi&atio& +et0ee& 2 a&d years
Fi&e $otor dee#op$e&t
Has impro9ed man8al deterit7 at === to === months
#hros a ?all ?7 === months
$ras circles ?7 === 7ears
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PSYCHOSOCIAL DEVELOPMENT
4e'i&s dee#op$e&t o( i&depe&de&!e a&d
se#(6!o&tro#
Eri,so& A"to&o$y ers"s s%a$e a&d
do"+t
Ne'atiis$Rit"a#i8atio& proides a se&se o( !o$(ort
Id1 e'o1 a&d s"pere'o *!o&s!ie&!e-
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COGNITIVE DEVELOPMENT
Pia'et
!ensorimotor phases#ertiar7 circ8lar reactions at 13 to 1 months
In9ention of ne means thro8h mental
com?inations at 1- to 2 months
Imitation and domestic mimicr7 are commonAareness of ca8sal relationships ?eteen to
e9ents Bpro?lem sol9in and operations
earns spatial relationships
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DOMESTIC MIMICRY
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SPIRITUAL DEVELOPMENT
Spirit"a# dee#op$e&t o(te& para##e#s !o'&itie
dee#op$e&t
Spirit"a# ro"ti&es !a& +e !o$(orti&'
Re#i'io"s tea!%i&'s a&d $ora# dee#op$e&t i&(#"e&!etodd#er +e%aior
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DEVELOPMENT OF 4ODY
IMAGE4ody i$a'e !#ose#y para##e#s !o'&itie
dee#op$e&t a&d se#(6a0are&ess
Re(ers to +ody parts +y &a$e
Aoid &e'atie #a+e#s a+o"t p%ysi!a# appeara&!e
Re!o'&i8es 'e&der di((ere&!es +y a'e 2 years
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DEVELOPMENT OF SEJUALITY
E.p#oratio& o( 'e&ita#ia is !o$$o&
Ge&der ro#es are "&derstood +y a todd#er
Ge&der ide&tity is esta+#is%ed +y )))years
P#ayi&' =%o"se>
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LANGUAGE
I&!reasi&' #ee# o( !o$pre%e&sio&
I&!reasi&' a+i#ity to "&dersta&d
Co$pre%e&sio& o( 0ords +y a'e 2 years
At )))) years1 !a& "se t0o6 or t%ree60ord p%rases
At )))) years1 !a& "se si$p#e se&te&!es a&da!"ires (ie to si. &e0 0ords a day
Gest"res pre!ede ea!% #a&'"a'e $i#esto&e "p to
$o&t%s o( a'e
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PLAY
Para##e# p#ay
I$itatio&
Litt#e e$p%asis o& 'e&der6stereotyped toys
I&!reased #o!o$otie s,i##s Ed"!atio&a# toys a&d +oo,s
Ta!ti#e p#ay
Appropriate sa(ety i& re#atio& to si8e1 s%ape1 ris, (or
to.i&s1 a&d st"rdi&ess o( toys
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COPIN5 @ITH CONCERNS RELATEDCOPIN5 @ITH CONCERNS RELATED
TO NORMAL 5RO@TH ANDTO NORMAL 5RO@TH AND
DEVELOPMENTDEVELOPMENT!oilet training!oilet training#ibling rivalry#ibling rivalry
!emper tantrums!emper tantrums Co,siste,.Co,siste,.
=egativism=egativism
(egressive behavior(egressive behavior Co,ser)e +s.hi. e,erg b re)erti,gCo,ser)e +s.hi. e,erg b re)erti,g
to +atter,s +re)ios s..ess-to +atter,s +re)ios s..ess-
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ASSESSING READINESS FOR TOILET
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ASSESSING READINESS FOR TOILET
TRAINING
Vo#"&tary sp%i&!ter !o&tro#
A+i#ity to stay dry (or 2 %o"rs
Fi&e $otor s,i##s to re$oe !#ot%i&'
Wi##i&'&ess to p#ease pare&ts
C"riosity a+o"t ad"#t/s or si+#i&'/s toi#et
%a+its
I$patie&!e 0it% 0et or soi#ed diapers
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De&ta# %ea#t%N"tritio&
Phenomenon of ph7sioloic anoreiaDraEin
(7Plate recommendations
$rin)s 2 to 30 o8nces of mil) per da7 and eats 1 c8p
of fr8it per da7S#eep a&d a!tiity
!leeps for 11 to 12 ho8rs per da7
Has an ad8lt sleep pattern ?7 ae 3 7ears
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IN7URY PREVENTION
Motor e%i!#e i&5"ries *!ar seat
sa(ety-
Dro0&i&'
4"r&s
Poiso&i&'
Aspiratio& a&d s"((o!atio&4odi#y da$a'e *(a##s1 +ei&' str"!,1
+ites or sti&'s-
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CHAP#R 13
HA#H PR.(.#I." . #H
PR!CH..R A"$ A(I
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PR.(.#I"D .P#I(;( DR.>#H
A"$ $+.P("# T%e pres!%oo# period #asts (ro$ a'e to
years
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4IOLOGIC DEVELOPMENT
P%ysi!a# 'ro0t% s#o0s a&d sta+i#i8es
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GROSS MOTOR SKILLS
Gross $otor s,i##s s%o"#d +e 0e##6esta+#is%ed
>al)in
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P!CH.!.CIA $+.P("#
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C.D"I#I+ $+.P("#
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I,titi)e thoght +hase at to 6 ears
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gocentricity is still evident
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C.D"I#I+ $+.P("#
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CHAP#R 15
HA#H PR.(.#I." . #H
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(A#;RA#I." . !!#(!4#adder !apa!ity i&!reases
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PRP;%!C"CDe(i&ed as t%e 2 years pre!edi&' p"+erty
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P!CH.!.CIA $+.P("#
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PIAD#' C.D"I#I+
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PA
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PA BC."# $
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$+.PI"D A !C."CP#
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!ID"IICA"# A$;#!
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Eri,so& Se&se o( ide&tity
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diff8sion
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$+.P("#For$a# operatio&s period
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$+.P("#I&ter&a#i8ed set o( $ora# pri&!ip#es
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So$e $ay "estio& t%e a#"es a&d +e#ie(s o(
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Goa# is to de(i&e o&e/s ide&tity i&depe&de&t#y (ro$ pare&ta#
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Peers ass"$e a& i&!reasi&'#y si'&i(i!a&t ro#e i&ado#es!e&!e *=+est (rie&d>-
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Dati&'
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A"$ %.$ I(AD
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$;RI"D A$.!C"C BC."#G$Stress red"!tio&
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Motor e%i!#e !ras%es are t%e si&'#e 'reatest
!a"se o( serio"s a&d (ata# i&5"ries i& tee&sOt%er e%i!#es
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CAR . A(II!Pare&ts &eed s"pport a&d '"ida&!e
I&(or$atio& &eeds re'ardi&'
dee#op$e&ta# !%a&'es a&d
pro!ess o( 'ai&i&' i&depe&de&!e
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