Preschool Child Development (Ages 3-5)

• Focuses on the growth and development of preschool children, typically aged 3-5
• Aims to help students to understand normal development, assess milestones, and formulate nursing diagnoses

Introduction

• The preschool period includes ages 3, 4, and 5
• Growth slows during these years
• Children want to do things independently
• Preschoolers from ages 3 to 5 are smart, competent, skilled, verbal, egocentric, and enthusiastic
• Healthy preschoolers typically have a slender build, good posture, and are attractive
• Attention spans are limited in preschoolers

Physical Growth

• The average weight gained is about 4.5 lb (2 kg) per year
• Height increases by 2 to 3.5 inches (6 to 8 cm) per year on average
• Appetite remains consistent with toddler years

Physiological Growth

• Pulse rate decreases to about 85 beats/min
• Blood pressure stabilizes around 100/60 mmHg
• Genu valgus (knock-knees) may be present at the beginning, but typically disappears
• By age 3, children have all 20 deciduous teeth, which are not replaced by permanent teeth until school age

Development Milestones at Age 3

• Fine motor skills development involves undressing self, stacking blocks, and drawing a cross
• Gross motor skills development involves running, alternating feet on stairs, riding a tricycle, and standing on one foot
• Vocabulary consists of about 900 words
• Play habits include taking turns and imaginative play

Development Milestones at Age 4

• Fine motor skills development includes the ability to do simple buttons
• Gross motor skills development involves constant motion, jumping, and skipping
• Vocabulary consists of 1,500 words
• Play habits include pretending as a major activity

Development Milestones at Age 5

• Fine motor skills development includes drawing a six-part figure and lacing shoes
• Gross motor skills development involves throwing overhand
• Vocabulary consists of 2100 words
• Play habits include enjoying games with numbers or letters

Emotional Development (Erikson's Theory)

• Key Task: to achieve a sense of initiative versus guilt
• Encouragement enables them to explore, play and learn
• Criticism may lead to long-term decision-making issues
• Trips to the zoo or vacations can enhance vocabulary and foster initiative

Social Development

• Preschoolers exhibit peak imitation, imitating people around them
• Role modeling involves exploring roles, which does not have to be accurate
• Boys imitate firefighters, girls set tables and "work" like parents as examples
• Parents should explain real-life roles without interrupting imaginative play

Intellectual Development

• Fantasy play distinguishes fantasy from reality, but children may get lost in imagination
• Magical thinking makes children believe in thoughts and wishes coming true
• Acknowledge the fantasy while reassuring the child’s identity

Socialization and Gender Roles

• Preschoolers begin cooperative play by age 3 and form friendships by age 5
• They recognize gender roles through observation
• Parental actions reinforce attitudes about gender, even unintentionally
• Encouraging interactions with adults of both genders can lead to better role understanding

Cognitive Development

• Stage of development is preoperational (Piaget, 1969)
• Intuitional thought means preschoolers cannot view themselves as others do (Centering)
• Exhibit a lack of conservation, unable to understand that changes in form do not change the amount
• They may not grasp that two similar procedures are the same if presented differently

Cognitive Development Continued

• Centering means preschoolers feel they are always right and struggle to see others' perspectives
• An example of lack of conservation includes viewing two equal balls of clay, one squashed and one intact, as different in size
• Explain procedures consistently to avoid confusion

Moral Development (Kohlberg's Theory)

• Understanding of right vs. wrong is based on parents’ rules, not rational
• Moral reasoning is dependent on parental guidance
• Applying known rules may be a struggle in new situations

Spiritual Development

• Basic spiritual ideas are formed with exposure to religious training
• Good behavior is often motivated by personal gain, not spiritual conviction
• Comfort is found in religious rituals/holidays, much like familiar nursery rhymes

Promoting Preschooler Safety

• Preschoolers need close monitoring to avoid injuries
• Hazardous items like lawn-mowers, pools, and medication must be kept out of reach
• Guns should be locked away and kept separate from ammunition

Keeping Children Safe, Strong, and Free

• Teach children to avoid talking to or accepting rides from strangers
• Teach children emergency skills for help via 911
• Teach children to report bullying from peers or adults

Motor Vehicle and Bicycle Safety

• Use booster seats in the backseat and always utilize seatbelts
• Helmets are essential for preventing head injuries in preschoolers
• Parents should wear helmets when riding to encourage children to do the same

Promoting Preschooler Nutrition

• Appetite decreases with slowed growth
• Encourage healthy snacks
• Sources of calcium, vitamin D, and vitamin B12 are required for children on a vegetarian diet

Care of Teeth and Hygiene

• Parents should supervise brushing and flossing to ensure thorough cleaning
• Healthy snacks and fluoride must be encouraged to prevent decay
• Schedule the first dentist visit by age 3 to evaluate development

Common Health Problems

• Ear Infections (Otitis Media)
• Respiratory Infections
• Gastrointestinal Disturbances
• Higher incidence of infections in children exposed to smoke
• Major cause of death by Automobile accidents
• Frequent infections and minor ailments can lead to behavioral changes like whining or clinginess
• Parental Overprotection issues

Common Fears

• Fear of the dark
• Fear of mutilation
• Fear of separation or abandonment

Behavioral Problems

• Telling tall tales
• Imaginary friends
• Difficulty sharing
• Regression. Preschoolers under stress may revert to previous behaviors like thumb-sucking, loss of bladder control, and separation anxiety
• Sibling rivalry

Other Behavioral Problems

• Thumb sucking
• Food likes and dislikes
• Enuresis / Encopresis
• Selfishness
• Bad language
• Aggression & Hurting others
• Destructiveness

Needs of the Preschool Child

• Learning language
• Associative play
• Responsiveness to questions
• Medical supplements
• Dental care
• Sleep (12 hours at night, infrequent daytime naps)

Summary

• Nurses are crucial in promoting health/development through assessments, guidance, and promotion
• Early identification of health concerns is made possible through monitoring of physical, cognitive, and psychosocial development
• Providing parent education fosters supportive environments for children's well-being