Chapter 25 Growth and Development of the Preschool Child: 3 to 6 Years

Growth and Development of the Preschool Child Preschoolers’ language, play patterns, and appearance change markedly Soak up information “like a sponge” 3 years: Still chubby-faced, like a toddler 5 years: Leaner, taller, better coordinated social being Work and play tirelessly Fantasy versus reality Erikson: Initiative versus guilt

Physical Development Growth rate Slowed Gains 3 to 5 lb each year (1.4 to 2.3 kg) Grows about 2.5 in (6.3 cm) Gross, fine motor skills continue to develop rapidly Balance improves Confidence emerges to try new activities By age 5, can throw and catch a ball well, climb effectively, and ride a bicycle

Physical Development (cont.) Dentition By 6 years: Child’s skull is 90% of adult size Beginning of preschool stage: Deciduous teeth have completely emerged End of preschool stage: Begin to be replaced by permanent teeth Age of eruption of permanent teeth varies Central incisors are usually the first to go

Physical Development (cont.) Visual development Visual development is still immature at age 3 Eye–hand coordination is good Distance judgment faulty Screen for amblyopia Usually by age 6 the child has achieved 20/20 vision Mature depth perception may not occur until 8 to 10 years

Physical Development (cont.) Skeletal growth Between 3 and 6 years: Most skeletal growth occurs in feet and legs Carpals and tarsals mature giving better hand and foot control

Psychosocial Development (cont.) Language development Generally rapid 3-year-old has noncommunicative language 4-year-old has communicative language 4- and 5-year-olds like to use “naughty” words

Psychosocial Development (cont.) Language development (cont.) Factors causing delays or other difficulties Hearing impairment Other physical problem Lack of stimulation Overprotection Lack of parental interest or rejection

Psychosocial Development (cont.) Language development (cont.) Developing good language skills Converse with the preschooler in language they can understand Read to the preschooler Praise, approve, and encourage Family and cultural patterns

Question What age group delights in using swear words? a. 3 to 4 years b. 4 to 5 years c. 5 to 6 years d. 6 to 7 years

Answer b. 4 to 5 years Rationale: 4- and 5-year-old children delight in using “naughty” words or swearing. Bathroom words become favorites, and taunts such as, “You’re a big doo-doo” bring heady excitement to them.

Psychosocial Development (cont.) Development of imagination Magical thinking makes it difficult to separate fantasy from reality Makes preschoolers good audiences for storytelling, simple plays, and television May lead to imaginary playmates who are very real to them Often leads to a fear of the dark or nightmares and sleep problems

Psychosocial Development (cont.) Sexual development Acutely aware of their sexuality, including sexual roles and organs Generally develop strong emotional attachment to the parent of the opposite sex Curiosity about sex may make parents uncomfortable and can evoke negative responses

Psychosocial Development (cont.) Sexual development (cont.) Caregiver should responsibly teach accurate sexual information Teaching difference between “good touch” and “bad touch” Exploration of the genitalia normal, natural Calm, matter-of-fact response to masturbation most effective Inappropriate in public; limited use

Psychosocial Development (cont.) Play: Preschoolers use imitative play Types of play: All types needed for total development Dramatic play Act out troubling situations and control the solution to a problem Cooperative play Organized groups and team play Helps develop social interaction skills

Psychosocial Development (cont.) Play (cont.) Associative play Play together engaged in a similar activity but without organization, rules, or a leader Each child does what he or she wishes Solitary independent play Playing apart from others without making an effort to be part of the group or group activity

Psychosocial Development (cont.) Play (cont.) Onlooker play Observation without participation: Watching TV Unoccupied behavior Daydreaming, handling clothing or toy with no apparent purpose

Psychosocial Development (cont.) Aggression Early form – temper tantrums 4-year-olds push, hit, and kick: Manipulate environment Children from unhappy home situations more likely to be aggressive Observation of adult behavior reinforces aggression

Psychosocial Development (cont.) Discipline Teach child sense of responsibility, inner control Consistency important Physical punishment removes responsibility from child Taking away a privilege more effective

Psychosocial Development (cont.) Nursery school or day care experience Group experiences outside immediate family Can be frightening Preschooler will demand increased attention when returns to family members The disadvantaged child: Unable to achieve sense of security and trust; many causes Population most likely to have health problems and need services Need environmental enrichment

Psychosocial Development (cont.) The disadvantaged child (cont.) Head Start programs Federally funded, free to children Broaden child’s horizons via varied experiences Family caregiver participation essential Teach motor, cognitive, self-help, and language skills Provide counseling, referral services Prepares child to enter school Prepares child to compete successfully with peers

Question Tell whether the following statement is true or false. Play is an important part of the preschooler’s life. Preschool children who spend time playing interactive video games are said to be engaged in onlooker play.

Answer False Rationale: Watching television is one form of onlooker play in which there is observation without participation. Playing interactive video games would be an example of solitary independent play.

Nutrition Do not need large quantities of food Protein needs continue to remain high for muscle growth Appetite is erratic Portions are smaller than adult-sized portions Best to have frequent, small meals with snacks in between Need guidance in choosing foods Rituals may become important

Health Promotion and Maintenance Routine checkups Boosters of vaccinations Given between 4 and 6 years Annual health examination Monitors child’s growth and development Screens for health problems

Health Promotion and Maintenance (cont.) Routine checkups (cont.) Recommended screening procedures Urinalysis Hematocrit Lead level Tuberculin skin testing Denver Developmental Screening Test Vision Hearing

Health Promotion and Maintenance (cont.) Family teaching Bathing Still need supervision in tub Turn down water heater ≤120°F Discourage play with faucets Cannot wash own hair Teach to wash front and back of hands

Health Promotion and Maintenance (cont.) Family teaching (cont.) Dressing Let child choose clothes when possible Dental care Needs supervision Caregiver should floss Provide healthy snacks (veggies, etc.)

Health Promotion and Maintenance (cont.) Family teaching (cont.) Toileting Accidents can occur Teach hand washing before and after toileting Teach girls to wipe from front to back Bed-wetting not uncommon Sleep May give up nap Monsters; dreams and nightmares

Health Promotion and Maintenance (cont.) Accident prevention: Curiosity still exceeds judgment Common accidents: Burns, poisonings, and falls Seat belt use Wearing bicycle safety helmet Practicing street safety Stranger danger Fire drills Swimming safety

Health Promotion and Maintenance (cont.) Infection prevention Teach Cough or sneeze into bent elbow; dispose of tissues properly Correctly wiping after toileting; good hand washing Wash hands before eating Don’t eat fallen food; wash fallen utensil immediately Not sharing cups, utensils, food, or toothbrushes

The Preschooler in a Health Care Facility Use play: Act out anxieties Communicate upcoming events during hospitalization Do not use a rectal thermometer Do not scold a child for reverting to bed-wetting Follow home routines as closely as possible Carefully explain all procedures to preschoolers in language they understand Provide play material

Question Bathing is still a fun time for most preschoolers. Many exciting times can be had splashing in the tub with favorite toys. What temperature should water heaters maintain in order to prevent accidental burns? a. 110°F b. 115°F c. 120°F d. 125°F

Answer c. 120°F Rationale: The hot water heater should be turned to no higher than 120°F (49°C) to avoid the danger of burns.