1. Emotional & Behavioural Aspects of Preschool Children. Dr. P Phyu Consultant Paediatrician ST1-3 Training Day 6 th June 2012

2. Normal Emotional Development 0-1 month Adjusting to life outside the womb Crying is normal Needs to feel calm, safe & to have routine 2-3 months Show wide variety of feelings - smile, cry, coo, movements Comforted by being fed/cuddled Beginning to settle in more regular routines

3. Normal Emotional Development 4-6 months Laughs/ makes happy sounds Calm when picked up/hear familial voices 6-12 months Stranger awareness Enjoy attention Emotional expressions to fear/sadness

4. Normal Emotional Development 12-18 months Negative emotions Afraid of being apart from parents Needs comfort/reassurance 2 years Becoming more independent Extreme behaviours Little concept of sharing Easily distractible Likes routine Afraid of noises

5. Normal Emotional Development 3 – 5 years Learn to share Begin to seek adequate role models from whom they learn

6. Routines/ Good Habit Training Basic training in habits of daily life - important developmental task - parents seem to find difficult

7. The Development Sequence of Everyday Habits HabitsAge Regular feeding1 – 3 months Good sleep routine4 – 12 months Dressing/undressing1 – 2 years Toileting2 – 4 years Eating 3 – 5 years Self Care 4 – 6 years

8. Sleep Problems Incidence:1 in 3 up to 5 year-olds Management: 1.Establishing a good regular routine sleeping habit/pattern 2.Minimal contact (provided that child is safe and well) if the child cries or wakes up 3.NO hypnotics

9. Food Refusal in Toddlers Developmental – Asserting independence Rate of growth – much slower than 1 st year Management: Reassure – if growth is adequate Evaluate nutritional state General advice - make the meal time enjoyable events - avoid drawing attention to poor eating - sensible snacks between the meals

10. Temper Tantrums Age: 18 months – 4 years Terrible twos Precipitants: Tired, Hungry, Frustrations Management Avoid precipitants Distract General behaviour management - Ignore tantrums (provided that the child is safe) - Praise – good/ desirable behaviour - Uniformed approach - Spend time with child when good Time out

11. Role of multi-disciplinary professionals Midwives Health Visitors Nursery Nurses Sure Start General Practitioners Paediatricians