preschool age

What is an important first step when meeting a child and family?

Introduce yourself and learn the names and relationships of everyone present.

How should caregivers initially be addressed?

Formally, such as Mr., Ms., or their preferred title, until invited to use another name.

What type of questions should be used when obtaining a pediatric history?

Start with open-ended questions and then use specific questions for clarification.

Why should clinicians avoid assumptions about family structure?

Families have many different structures, relationships, cultures, and caregiving arrangements.

Who is often the best source of information about a child?

The child's caregiver or family.

How should clinicians view families during pediatric care?

As partners and important resources who know the child well.

What is important when communicating directly with a child?

Use language and explanations appropriate for the child's developmental level.

How can rapport be built with an anxious young child?

Use play, simple conversation, toys, and allow the child time to become comfortable.

What is developmental surveillance?

Ongoing monitoring of physical, cognitive/language, social-emotional, and behavioral development.

What should happen when developmental delays are identified?

The child should receive further evaluation and early intervention when indicated.

What happens to physical growth during early childhood compared with infancy?

Growth slows considerably.

Approximately how much weight may a toddler gain per year around age 2?

About 2-3 kg per year.

Approximately how much height may a toddler gain per year around age 2?

About 5 cm per year.

What happens to body proportions during early childhood?

They gradually become more adult-like.

By what age do most children walk independently?

Approximately 15-18 months.

What gross motor skill is usually well developed by about age 2?

Running.

What fine motor activity is expected around 18 months?

Scribbling.

What drawing skill may a 2-year-old demonstrate?

Drawing a vertical line.

What drawing ability develops around age 3?

Drawing a simple person and beginning to copy simple shapes or letters.

What happens to fine motor skills during early childhood?

They progressively improve as neurologic maturation occurs.

What type of thinking develops during early childhood?

Symbolic thought and imaginative thinking.

What is symbolic thought?

The ability to use words, objects, or images to represent something else.

What type of play becomes prominent during early childhood?

Imaginative or pretend play.

What happens to language during early childhood?

Vocabulary and sentence complexity increase rapidly.

Approximately how many words may an 18-month-old use?

About 10-20 words.

What happens to language around age 2?

Vocabulary expands and the child begins using short phrases or sentences.

What should a clinician consider if a child's language development is significantly delayed?

Further developmental evaluation and possible early intervention.

What social behavior becomes increasingly important during early childhood?

Developing independence.

What type of play is commonly associated with toddlers?

Parallel play.

What is parallel play?

Children play beside one another but do not necessarily interact or cooperate in the same activity.

Why are temper tantrums common during early childhood?

Self-regulation is still developing while the child is seeking greater independence.

What should health promotion during early childhood include?

Growth monitoring, developmental surveillance, immunizations, nutrition, oral health, safety, and age-appropriate play.

Why is play important during early childhood?

It supports motor, cognitive, language, emotional, and social development.

What should caregivers be encouraged to provide for toddlers?

Safe opportunities for age-appropriate play and increasing independence.

What age range is considered middle childhood in this chapter?

Approximately 5-10 years.

What happens to physical growth during middle childhood?

Growth becomes steady and strength and coordination improve.

What happens to motor abilities during middle childhood?

Strength, coordination, and physical skills progressively improve.

What cognitive stage develops during middle childhood?

Concrete operational thinking.

What is concrete operational thinking?

Logical thinking about concrete, real-life objects and situations.

What happens to memory during middle childhood?

Memory capacity and strategies improve.

What happens to academic tasks during middle childhood?

They become increasingly complex.

Why is school performance important during middle childhood?

It provides information about cognitive, language, behavioral, and social development.

What becomes increasingly important socially during middle childhood?

Peer relationships.

What happens to self-esteem during middle childhood?

It continues to develop and is influenced by family, peers, school, and achievement.

What influences a child's social identity during middle childhood?

Family relationships, peers, school experiences, and activities.

What health-promotion areas are important during middle childhood?

Healthy nutrition, physical activity, school success, developmental/behavioral surveillance, safety, and social well-being.

What should be observed before touching a young child during the physical examination?

Appearance, behavior, speech, play, movement, interaction with caregivers, and overall comfort.

Why should the clinician observe the child before beginning the hands-on exam?

The child's natural behavior provides useful developmental and physical information.

Where can a toddler be examined if the child is anxious?

On the caregiver's lap.

What is the best general order for examining a toddler?

Observe first, perform least invasive procedures first, and save painful or distressing procedures for last.