They appear taller and They appear taller and thinner than toddlers thinner than toddlers because children tend to because children tend to grow more in height than in grow more in height than in weight.weight.

The preschooler’s brain The preschooler’s brain almost reaches its adult size almost reaches its adult size by 5 years.by 5 years.

The extremities of the body The extremities of the body grow more quickly than the grow more quickly than the body trunk.body trunk.

The posture of preschoolers The posture of preschoolers gradually changes as the gradually changes as the pelvis is straightened and pelvis is straightened and the abdominal muscles the abdominal muscles become stronger. They become stronger. They appear slender with erect appear slender with erect posture. posture.

Weight:Weight: Weight gain in preschool children is generally slow. Weight gain in preschool children is generally slow.

By 5 years they have added only another 3 to 5 kg (7 By 5 years they have added only another 3 to 5 kg (7 to 12 lb) to their 3 year-old weight, increasing it to to 12 lb) to their 3 year-old weight, increasing it to somewhere between18 and 20 kg (40 and 45 lb)somewhere between18 and 20 kg (40 and 45 lb)

Height:Height: Preschool children grow about 5 to 6.25 cm (2.0 to Preschool children grow about 5 to 6.25 cm (2.0 to

2.5in.) each year. Thus by 5 year of age they double 2.5in.) each year. Thus by 5 year of age they double the birth length and measure 100cm (40in.).the birth length and measure 100cm (40in.).

Vision:Vision:

Preschool children are generally hyperopic Preschool children are generally hyperopic (farsighted), that is unable to focus on near (farsighted), that is unable to focus on near objects.objects.

As the eye grows in length, it becomes As the eye grows in length, it becomes emmetropic (it refracts light normally). emmetropic (it refracts light normally).

If the eyes become too long, the child If the eyes become too long, the child becomes myopic (nearsighted), that is becomes myopic (nearsighted), that is unable to focus on objects that are far away.unable to focus on objects that are far away.

Normal vision for the 5-year-old is Normal vision for the 5-year-old is approximately 20/30.approximately 20/30.

Hearing and Taste:Hearing and Taste:

The hearing of the preschool The hearing of the preschool child has reached optimal levels, child has reached optimal levels, and the ability to listen has and the ability to listen has matured since the toddler age.matured since the toddler age.

For the sense of taste, For the sense of taste, preschoolers show their preschoolers show their preferences by asking for preferences by asking for something “yummy”, and may something “yummy”, and may refuse something they consider refuse something they consider “yucky“yucky””

Motor Abilities:Motor Abilities: By 5 years of age, By 5 years of age,

children are able to wash children are able to wash their hands and face and their hands and face and brush their teeth.brush their teeth.

They are self-conscious They are self-conscious about exposing their about exposing their bodies and go to the bodies and go to the bathroom without telling bathroom without telling others.others.

They run skillfully and can They run skillfully and can jump three steps, they jump three steps, they can balance on their and can balance on their and dress themselves without dress themselves without assistance.assistance.

(Eric Erikson)(Eric Erikson)Initiative versus GuiltInitiative versus Guilt Preschoolers must solve problems in Preschoolers must solve problems in

accordance with their consciences. accordance with their consciences. Erikson views the crises at this time Erikson views the crises at this time as important for the development of as important for the development of the individual’s self-concept.the individual’s self-concept.

Preschoolers must learn what they Preschoolers must learn what they can do. As a result, preschoolers can do. As a result, preschoolers imitate behavior, and their imitate behavior, and their imaginations and creativity become imaginations and creativity become lively.lively.

Parents can enhance the self-concept Parents can enhance the self-concept of the preschooler by providing of the preschooler by providing opportunities for new achievements opportunities for new achievements where the child can learn, repeat, and where the child can learn, repeat, and master.master.

The self-concept of the preschooler is The self-concept of the preschooler is also based on gender identification. also based on gender identification. Preschoolers are aware of the two Preschoolers are aware of the two sexes and identify with correct one. sexes and identify with correct one. They often imitate sexual stereotypes They often imitate sexual stereotypes and usually begin by identifying with and usually begin by identifying with the parent of the same sex. the parent of the same sex.

They may mimic the parent’s They may mimic the parent’s behavior, attitudes, and appearancebehavior, attitudes, and appearance..

(Freud)(Freud)Phallic Stage of DevelopmentPhallic Stage of Development

The biologic focus of the child The biologic focus of the child during this day is the genital during this day is the genital area.area.

The phase of close emotional The phase of close emotional relationships with both parents’ relationships with both parents’ changes to the phase Freud changes to the phase Freud referred to as the Electra and referred to as the Electra and Oedipus complex.Oedipus complex.

The child focuses feelings of The child focuses feelings of love chiefly on the parent of the love chiefly on the parent of the opposite sex, and the parent of opposite sex, and the parent of the same sex may receive the same sex may receive some hostile feelings.some hostile feelings.

The child begins to develop The child begins to develop sexual interest and becomes sexual interest and becomes interested in clothes and hair interested in clothes and hair styles.styles.

Sexual CuriositySexual Curiosity

When guiding parents concerning the sexual education When guiding parents concerning the sexual education of young children, the nurse should use the following of young children, the nurse should use the following principles of teachingprinciples of teaching

First assess the knowledge base of the childFirst assess the knowledge base of the child Be honest and accurate in providing information at the Be honest and accurate in providing information at the

child’s levelchild’s level Use correct terminology so that misinformation or Use correct terminology so that misinformation or

misinterpretation can be avoidedmisinterpretation can be avoided Provide sex education at the time the child asks the Provide sex education at the time the child asks the

questionquestion Parents must understand that sexual curiosity starts as Parents must understand that sexual curiosity starts as

an inquiry into anatomical differences`an inquiry into anatomical differences`

MasturbationMasturbation

Masturbation is common in both genders during Masturbation is common in both genders during the preschool yearsthe preschool years

The child experiences pleasurable sensations The child experiences pleasurable sensations which lead to a repetition of the behaviorwhich lead to a repetition of the behavior

Masturbation in the preschool child is considered Masturbation in the preschool child is considered harmless if the child is outgoing, sociable and harmless if the child is outgoing, sociable and not preoccupied with the activity not preoccupied with the activity

Education of the parents consists of assuring Education of the parents consists of assuring them that this behavior is a form of curiosity and them that this behavior is a form of curiosity and is normal and not harmful to the childis normal and not harmful to the child

Four Adaptive MechanismsFour Adaptive Mechanisms

Identification –Identification – occurs when the child perceives the self occurs when the child perceives the self as similar to another person and behaves like that as similar to another person and behaves like that person.person.

Introjection –Introjection – is similar to identification. It is the is similar to identification. It is the assimilation of the attributes of assimilation of the attributes of others. When others. When preschoolers observe their parents, they assimilate preschoolers observe their parents, they assimilate many of their values and attitudes.many of their values and attitudes.

Imagination –Imagination – is an important part of preschooler’s is an important part of preschooler’s lives. The preschooler has an active imagination and lives. The preschooler has an active imagination and fantasizes in play.fantasizes in play.

Repression –Repression – is removing experiences, thoughts, and is removing experiences, thoughts, and impulses from awarenessimpulses from awareness..

The Three Year Old The Three Year Old

They are helpful and can They are helpful and can assist in simple choresassist in simple chores

Temper tantrums are Temper tantrums are less frequentless frequent

They can help dress and They can help dress and undress themselvesundress themselves

They eat independently They eat independently and table manners have and table manners have improvedimproved

Can talk in longer Can talk in longer sentences and can sentences and can express thoughts and express thoughts and ask questionsask questions

Parallel play (playing Parallel play (playing independently within a independently within a group) and associative group) and associative play are typical of this play are typical of this age periodage period

The Four Year OldThe Four Year Old

The four year olds are more The four year olds are more aggressive and like to show aggressive and like to show off newly refined motor off newly refined motor skillsskills

Four year olds are Four year olds are boisterous, tattle on others, boisterous, tattle on others, and may begin to swear if and may begin to swear if they are around children or they are around children or adults who use profanityadults who use profanity

At this age children become At this age children become interested in how old they interested in how old they are and want to know the are and want to know the exact age of each playmateexact age of each playmate

Four year olds can use Four year olds can use scissors with successscissors with success

There vocabulary has There vocabulary has increased to about 1500 increased to about 1500 wordswords

Raw materials are more Raw materials are more appealing to a four year old appealing to a four year old then toys that are already then toys that are already made made

The Five Year OldThe Five Year Old

The five year old is more The five year old is more responsible, enjoy doing responsible, enjoy doing what is expected of them, what is expected of them, have more patients and like have more patients and like to finish what they startedto finish what they started

They talk constantly and are They talk constantly and are inquisitive about their inquisitive about their environmentenvironment

There height may increase There height may increase by 2 to 3 inches, and may by 2 to 3 inches, and may gain 3 to 6 pounds gain 3 to 6 pounds

They may begin to lose their They may begin to lose their deciduous teeth at this timedeciduous teeth at this time

They can usually print They can usually print there first namethere first name

At the age of 3 or 4, they learn to play with a small At the age of 3 or 4, they learn to play with a small number of their peers. They gradually learn to play with number of their peers. They gradually learn to play with more people as they grow older.more people as they grow older.

In their speech, children of 4 years are often dogmatic; In their speech, children of 4 years are often dogmatic; they tend to believe that what they know is right.they tend to believe that what they know is right.

At 4, Children are aggressive in their speech and capable At 4, Children are aggressive in their speech and capable of long conversations, often mixing fact and fiction. By 5 of long conversations, often mixing fact and fiction. By 5 years of age, speaking skills are well-developed.years of age, speaking skills are well-developed.

They play with their bodies largely out of curiosity. They They play with their bodies largely out of curiosity. They know where the body begins and ends as well as the know where the body begins and ends as well as the correct names for the different parts.correct names for the different parts.

Preschoolers learn about their feelings. They also begin Preschoolers learn about their feelings. They also begin to learn how to control their feelings and behavior.to learn how to control their feelings and behavior.

They are interested in seeing new places and enjoy They are interested in seeing new places and enjoy going with the family on vacation- these activities going with the family on vacation- these activities lead to increased vocabulary and learn words which lead to increased vocabulary and learn words which they transfer from abstract concepts to the objects they transfer from abstract concepts to the objects to which they relate.to which they relate.

Types of PlayTypes of Play

Preschool children need Preschool children need playmates to promote social playmates to promote social developmentdevelopment

The Preschool child The Preschool child gradually moves from gradually moves from parallel and associative play parallel and associative play to cooperative play with to cooperative play with playmatesplaymates

Play should be Play should be noncompetitive and noncompetitive and supervised for safety supervised for safety

Imaginary friends are Imaginary friends are common in the preschool age common in the preschool age

They serve to help the They serve to help the child adjust to an expanding child adjust to an expanding world and increased world and increased independence independence

Some suitable toys for the Some suitable toys for the preschooler are large preschooler are large construction sets, number or construction sets, number or alphabet games, play tools, alphabet games, play tools, large puzzles and claylarge puzzles and clay

Active play can include Active play can include simple climbing, sliding and simple climbing, sliding and running running

Preparing for a new siblingPreparing for a new sibling

Introduction of a new sibling is Introduction of a new sibling is a major happening that parents a major happening that parents need to take special steps to be need to take special steps to be certain their preschooler will be certain their preschooler will be prepared. There is no rule when prepared. There is no rule when to begin, but it should be before to begin, but it should be before the time when the child begins to the time when the child begins to feel the difference the new baby feel the difference the new baby will make.will make.

SIBLING RIVALRY:SIBLING RIVALRY: jealousy of a brother or sister jealousy of a brother or sister

may first become evident during may first become evident during this period, partly because they this period, partly because they have enough vocabulary to have enough vocabulary to express how they feel.express how they feel.

(Piaget)(Piaget)Phase of Intuitive ThoughtPhase of Intuitive Thought

Children are egocentric. But egocentrism gradually Children are egocentric. But egocentrism gradually subsides as they experience their expanding world.subsides as they experience their expanding world.

Preschoolers learn through trial and error, and Preschoolers learn through trial and error, and they think of only one idea at a time.they think of only one idea at a time.

The child with a well-developed sense of The child with a well-developed sense of initiative discovers that learning about new initiative discovers that learning about new things is funthings is fun

They do not understand relationships such as those They do not understand relationships such as those Reading skills also start to develop at this age. Reading skills also start to develop at this age. Young children like fairy tales and books about Young children like fairy tales and books about animals and other children animals and other children

(Kohlberg)(Kohlberg)

Preschoolers are capable of prosocial behavior, Preschoolers are capable of prosocial behavior, that is, any action that a person takes to benefit that is, any action that a person takes to benefit someone else.someone else.

Prosocial –Prosocial – is synonymous with kind and connotes is synonymous with kind and connotes sharing, helping, protecting, giving sharing, helping, protecting, giving aid, befriending, showing affection, and aid, befriending, showing affection, and

giving giving encouragement.encouragement. Preschoolers do not have a fully formed conscience; Preschoolers do not have a fully formed conscience;

however, they do develop some internal controls. however, they do develop some internal controls. Moral behavior is largely learned by modeling, Moral behavior is largely learned by modeling, initially after parents and later significant others.initially after parents and later significant others.

Preschoolers usually control their behavior because Preschoolers usually control their behavior because they want love and approval from their parents. they want love and approval from their parents.

It is important for parents to answer preschoolers’ It is important for parents to answer preschoolers’ “why” questions and discuss values with them.“why” questions and discuss values with them.

(Fowler)(Fowler)

Children ages of 4 to Children ages of 4 to 6 years are at the 6 years are at the intuitive-projective intuitive-projective stage of spiritual stage of spiritual development.development.

Faith at this stage is Faith at this stage is primarily a result of primarily a result of the teaching of the teaching of significant others, significant others, such as parents and such as parents and teachers. They learn teachers. They learn to imitate religious to imitate religious behavior.behavior.

Children at this age Children at this age use their imaginations use their imaginations to envision such ideas to envision such ideas as angels or the devil.as angels or the devil.

Respiratory tract Respiratory tract problems and problems and communicable diseases communicable diseases frequently occur as the frequently occur as the preschooler interacts preschooler interacts with other children at with other children at nursery schools and day nursery schools and day care.care.

Accidents and dental Accidents and dental caries are problems caries are problems during this age.during this age.

Congenital Congenital abnormalities such as abnormalities such as cardiac disorders and cardiac disorders and hernias are often hernias are often corrected at this age.corrected at this age.

Accident PreventionAccident Prevention

Accidents are a major threat during the years Accidents are a major threat during the years from 3 – 5from 3 – 5

There injury may be related to a bad fall since There injury may be related to a bad fall since preschool children hurry up and down stairs, preschool children hurry up and down stairs, they play hard with there toys and like to climb they play hard with there toys and like to climb and stand on thingsand stand on things

When buying toys for the preschooler make sure When buying toys for the preschooler make sure they are sturdy and age appropriatethey are sturdy and age appropriate

Automobiles are threat, child should be taught Automobiles are threat, child should be taught where they can ride there bike and play with a where they can ride there bike and play with a ballball

Never leave the child alone in or around a carNever leave the child alone in or around a car Burns at this age usually occur from children Burns at this age usually occur from children

experimenting with matchesexperimenting with matches

Safety Safety

Burn from hot coffee are also commonBurn from hot coffee are also common These things should be kept high and out of reach These things should be kept high and out of reach

from the child from the child There dangers should also be explained to the childThere dangers should also be explained to the child Poisoning is also a danger since children in this age Poisoning is also a danger since children in this age

group try to imitate adults and are apt to sample pillsgroup try to imitate adults and are apt to sample pills Preschool children should also be taught the dangers Preschool children should also be taught the dangers

of talking to or accepting rides from strangers of talking to or accepting rides from strangers Parents should make it clear to children in nursery Parents should make it clear to children in nursery

school that they will never send a stranger to pick school that they will never send a stranger to pick them up them up

They should also be warned about the dangers of They should also be warned about the dangers of playing in places alone and accepting gifts from playing in places alone and accepting gifts from strangersstrangers

Preschooler development on daily Preschooler development on daily activitiesactivities

Preschoolers have often mastered Preschoolers have often mastered the basic skills needed for most the basic skills needed for most self-care activities including self-care activities including feeding, dressing, washing and tooth feeding, dressing, washing and tooth brushingbrushing

DRESSING: most of them can dress DRESSING: most of them can dress themselves except for difficult themselves except for difficult buttons, although there may be a buttons, although there may be a conflict with what the child would conflict with what the child would wearwear

SLEEP: they are aware of their SLEEP: they are aware of their heeds, when they are tired, they often heeds, when they are tired, they often curl up on the sofa or bed and fall curl up on the sofa or bed and fall asleepasleep

EXERCISE: this period is an active EXERCISE: this period is an active phase so they make a great deal of phase so they make a great deal of exerciseexercise

BATHING: they can wash and dry BATHING: they can wash and dry their hands perfectly adequately if their hands perfectly adequately if the faucet is regulated for themthe faucet is regulated for them

CARE OF TEETH: the child should CARE OF TEETH: the child should continue drinking fluorinated water continue drinking fluorinated water or receive a prescribed oral or receive a prescribed oral fluoride supplement if fluoride is fluoride supplement if fluoride is not provided in the water supply; not provided in the water supply; one good tooth brushing session a one good tooth brushing session a day is more often effective than day is more often effective than more frequent half-hearted brushingsmore frequent half-hearted brushings

Bedtime HabitsBedtime Habits

Parents should engage the child in quiet Parents should engage the child in quiet activities before bedtimeactivities before bedtime

StorytellingStorytelling Attention getting behavior that results in taking Attention getting behavior that results in taking

the child into the parents bedroom should be the child into the parents bedroom should be discouraged because it rewards bad behavior discouraged because it rewards bad behavior and defeats the purpose of bedtime ritualsand defeats the purpose of bedtime rituals

Health ExaminationsHealth Examinations Every 1 to 2 yearsEvery 1 to 2 years

Protective MeasuresProtective Measures Immunizations: continuing DPT, OPV series, MMR, Immunizations: continuing DPT, OPV series, MMR,

hepatitis, and other immunizations as recommended.hepatitis, and other immunizations as recommended. Screening for tuberculosis.Screening for tuberculosis. Vision and hearing screening.Vision and hearing screening. Regular dental screenings and fluoride treatment.Regular dental screenings and fluoride treatment.

Preschooler SafetyPreschooler Safety Educating child about simple safety rules.Educating child about simple safety rules. Teaching child to play safely.Teaching child to play safely. Educating to prevent poisoning.Educating to prevent poisoning.

NutritionNutrition Importance of nutritious meals and snacks.Importance of nutritious meals and snacks.

EliminationElimination Teaching proper hygiene.Teaching proper hygiene.

Rest/SleepRest/Sleep Dealing with sleep disturbances.Dealing with sleep disturbances.

PlayPlay Providing times for group play activities.Providing times for group play activities. Teaching child simple games that require Teaching child simple games that require

cooperation and interaction.cooperation and interaction. Providing toys and dress-ups for role-playing.Providing toys and dress-ups for role-playing.