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

2. 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

3. 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

4. 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

5. 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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.

12. 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

13. 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

14. 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

15. 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

16. 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

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

18. 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

19. 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

20. 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

21. 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

22. 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.

23. 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.

24. 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

25. 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

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

27. 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

28. 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.)

29. 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

30. 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

31. 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

32. 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

33. 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

34. 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.