1. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth and Development of the Preschool Child: 3 to 6 Years Chapter 20

2. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Physical Development of the Preschool Child Slowed growth rate Changes in dentition Changes in visual development Changes in skeletal growth, especially in the feet and legs

3. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Growth Rate of the Preschooler Gains about 3 to 5 lbs each year (1.4 to 2.3 kg) Grows about 2.5 inches (6.3 cm) Gross and 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

4. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Dentition in the Preschooler By 6 years: child’s skull is 90% of its adult size Beginning of preschool stage: deciduous teeth have completely emerged End of preschool stage: permanent teeth begin to be replaced by deciduous teeth –Age varies with individual children and with ethnic and economic groups –The central incisors are usually the first to go

5. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Visual Development of the Preschooler Visual development is still immature at age 3 Eye–hand coordination is good Judgment of distances generally is faulty Vision should be checked to screen for amblyopia Usually by age 6 the child has achieved 20/20 vision Mature depth perception may not occur in some children until 8 to 10 years of age

6. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Characteristics of the Psychosocial Development of the Preschooler Rapid language development Imagination Sexual and social development Variety of types of play

7. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors Affecting Language Development in the Preschooler Hearing impairment or other physical problem Lack of stimulation Overprotection Lack of parental interest or rejection by parents

8. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Development of Imagination in the Preschooler 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, nightmares, and sleep problems

9. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Development of Sexuality in the Preschooler They are acutely aware of their sexuality, including sexual roles and organs They generally develop a strong emotional attachment to the parent of the opposite sex Curiosity about sex may make parents uncomfortable and evoke negative responses The caregiver should teach responsible sexual information The caregiver should teach the child “good touch” and “bad touch”

10. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Preschooler Play Dramatic Cooperative Associative Parallel Solitary independent Onlooker Unoccupied behavior

11. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Role of Discipline for the Preschooler Teach responsibility and inner control Agree to limits and discipline measures –Spanking removes the responsibility from the child –Taking away a privilege is much more effective Keep the period brief –The child’s concept of time is not clear

12. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Goals of Head Start Programs Broaden child’s horizons through varied experiences Increase child’s understanding of his or her world Teach motor, cognitive, self-help, and language skills Provide counseling and referral services Prepare child to enter school Prepare child to compete successfully with peers

13. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Nutrition for the Preschooler Does 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 Frequent, small meals with snacks in between best accepted

14. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Health Promotion and Maintenance for the Preschooler Booster vaccinations –Given between 4 and 6 years of age Annual health examination –Monitors the child’s growth and development –Screens for health problems

15. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Recommended Screening Procedures for the Preschooler Urinalysis Hematocrit Lead level Tuberculin skin testing Denver Developmental Screening Test

16. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Topics for Family Teaching Bathing Dental care Dressing Toileting Sleep needs Accident prevention Infection prevention

17. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Topics of Teaching to Prevent Accidents in Preschoolers Seat belt use Wearing bicycle safety helmets Practicing street safety Stranger danger Fire drills Swimming safety

18. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Topics of Teaching to Prevent Infections in Preschoolers Covering mouth when coughing or sneezing Disposing of tissues properly Correctly wiping after bowel movements Good handwashing Not sharing cups, utensils, food, or toothbrushes

19. Copyright © 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins Nursing Care for the Preschooler in a Health Care Facility Use play to act out anxieties and learn what to expect from the hospital situation Do not use a rectal thermometer Do not scold a child for reverting to bedwetting Follow home routines as closely as possible Carefully explain all procedures to the child Provide play material