Preschooler, School Age, Child, & Adolescent GD

• Preschooler: 3-5 years

• School age: 6-12 years

• Adolescents: 13-18 years

What are each of the age groups for preschoolers, school age, adolescents?

Average increase of 5LBS/YEAR

What do weight changes look like in a preschooler?

Average increase of 2.5-3 INCHES/YEAR

What do height changes look like in a preschooler?

AGE 3

When do preschoolers have all 20 of their deciduous teeth?

• Loses baby fat, gains muscle (appears tall and slender)

• Should continue to follow established growth curves

What does the physical growth look like for a preschooler?

• Becomes increasingly independent

• Coordination and muscle strength increase rapidly, with wide variation in motor ability

• Fine and gross motor development is very different in 3 year olds compared to 5 year olds

• “Handedness” emerge (dominant hand)

• Greater social and emotional maturity

• Master's self-care and motor skills (can dress, eat, and go to the bathroom without help by 4-5 years of age)

• Imaginative, creative, and curious

• Need close supervision

What does the general development look like for a preschooler?

Unintentional injury

What is the high risk in the development of a preschooler?

Preoperational stage

What stage of Piaget’s cognitive development are preschoolers in?

• Magical thinking

• Animism

• Irreversibiity

• Centration

• Transducive reasoning

• Ritual, routine (provide child with sense of control)

What does the preoperational phase look like in preschoolers?

Magical thinking

Believes thoughts are all powerful and the cause of events; may be overwhelmed with guilt when unfortunate incident occur to those they love

Animism

Attributes life-like qualities to inanimate objects

Irreversibility

Cannot see a process in reverse order; walk somewhere but can’t get back

Centration

Focuses on one aspect of an experience; puzzles are hard; can’t follow more than one direction at a time (can’t see the big picture)

• ex.) cut up cake, think they have more

Transductive reasoning

Reasons from particular to particular; cannot focus on the general

• Linking unrelated events because events are close together in time

• Telegraphic speech (short, simple sentences)

• Talk to themselves

What does language development look like at 3 YEARS?

• Speaks in COMPLETE sentences

• Talks INCESSANTLY

• Expects more DETAILED answers to questions

What does language development look like at 4 YEARS?

• Speak in ADULT-LIKE sentences

• Can tell stories (combine FANTASY and REALITY)

• Many HOW and WHY questions at this age

What does language development look like at 5 YEARS?

Ignore

What should you do for “bad” language to extinguish it?

• Do not interrupt

• Speak in short sentences

• Designate time to talk to child and listen

• Restrict the number of questions you ask at a time

• Minimize stressful situtations for child

• Show child love and acceptance

How to prevent stuttering as language develops in preschoolers?

Initiative vs. Guilt

What stage of Erikson’s psychosocial development are preschoolers in?

• Developmental task is to gain a sense of initiative (busy learning how to DO NEW THINGS; take great PRIDE in accomplishments)

• Criticism or punishment may result in feelings of GUILT, ANXIETY, SHAME, and FEAR

• Encourage preschoolers’ imagination and creativity

• Preschoolers learn how to make and keep a FRIEND

What does initiative vs. guilt look like in preschoolers?

• INTERATIVE COMMUNICATION; thrive on one to one communication with parent and learn how to express their feelings

• Praise appropriate behavior and attempts to do things, even if not done well

• Want to know how things work, asks many questions; answer questions SIMPLY BUT TRUTHFULLY

How can you encourage a preschooler’s initiative in Erikson’s stage of development?

Body mutilation, pain, guilt/shame

What are the hospital fears for preschooler?

• COOPERATIVE PLAY (small groups, interacting)

• DRAMATIC PLAY

• SYMBOLIC PLAY

• IMAGINARY FRIEND

• Ride on toys, materials for building and drawing, dolls, cars, puzzles, books, appropriate TV shows, nonsense rhymes, singing, pretend play, dress up

What type of play do preschoolers develop?

• Likes to run, hop, jump

• Likes to build and create things

• Play is simple and simple collections begin

What does imaginative play look like in preschoolers?

Symbolic play

Allows them to work through distressing feelings (ex. NEEDLE PLAY)

A common part of this stage of development, creative way to SAMPLE activities/behaviors and PRACTICE CONVERSATION

What does having imaginary friends do for preschoolers development?

Phallic stage

What stage of Freud’s psychosocial development are preschoolers in?

• Jealousy and rivalry toward SAME SEX PARENT and loveof opposite sex parent

• Gender identity and body image are developing

• Sexual curiosity, anatomic exploration, and masturbation are common

• Children should not be shamed or punished for self-comforting behaviors (let them know if appropriate or not)

• Enourage parents to answer questions simply and honestly

What does the phallic stage for preschoolers look like?

Know sex differences

What does psychosexual development look like in preschoolers at age 3?

Gender identity is well established (ex. toys, clothes)

What does psychosexual development look like in preschoolers at age 6?

Preconventional morality (punishment-obedience orientation)

What stage of Kohlberg psychosocial development are preschoolers in?

• Determine what is GOOD VS BAD based on whether there is PUNISHMENT or not (DISCIPLINE IS IMPORTANT)

• Discipline should not be provided in a negative way

• Feel REMORSE if they behave badly

• Daily ROUTINE is important for learning GOOD BEHAVIOR

What does the preconventional morality stage of preschoolers look like?

• Milk products, but limited to 16-24 OZ

• Food jags

• LIMIT FATS and SUGARS

• Exercise and healthy choices are important

What does nutrition look like for preschoolers?

• Brushing after meals

• Fluoride supplements daily

What does dental care for preschoolers look like?

10-13 HOURS of sleep; often resistant to naps

• Bedtime rituals are important

What does sleep look like for preschoolers?

BOOSTER SEATS are used, once carseat is outgrown

What does car safety look like for preschoolers?

• Car safety

• Fire/burn

• Firearms (stored safely, teach)

• Personal

• Sexual abuse

What are the types of safety for preschoolers?

• Personal: how to call for help, telling adults if threatened

• Sexual abuse: tell adult if touched inappropriately

What does personal and sexual safety look like in preschoolers?

6-12 years

What is the age range of school age children?

• Height: 2 INCHES/YEAR

• Weight: 5 ½ LBS per YEAR

What does growth look like in school age children?

Between 8-13 years

• 2 YEARS EARLIER for girls

When does a GROWTH SPURT typically happen in school age children?

Children of the same age can be very different heights

• Expectations of behavior should be CONSISTENT WITH AGE, not appearance

What should you consider for physical growth in school age children?

• Brain growth is completed by 10 YEARS

• Have all permanent teeth

• Respiratory, cardiac, immune are matured

What does body system growth look like in school age children?

• Puberty

• Tanner stages (1-5); second sexual characteristics

• Girls vs. Boys

• Children need to be educated about changes to body prior to it happening (Sex Ed)

What does sexual development look like for school age children?

Puberty

Time of dramatic change with the development of secondary sexual characteristics

1. Thelarche (breast budding)

2. Pubic hair

3. Menarche (onset menstruation)

What does tanner stage development (in order) look like in GIRLS?

1. Pubic hair

2. Testicles/scrotal enlargement, penile enlargement

3. Voice changes

4. Gynecomastia (male breast enlargement)

5. Noctural emissions

What does tanner stage development (in order) look like in BOYS?

• Coordination, balance, rhythm improve

• Participation in sports and variety of activities

• May become AWKWARD as bodies growth faster than able to compensate

What does GROSS motor development look like in school age children?

• Improved HAND-EYE coordination and balance

• Takes PRIDE in activities requiring DEXTERITY; such as playing a musical instrument, sewing, building models

What does FINE motor development look like in school age children?

Concrete operational

What stage of Piaget’s cognitive development are school age children in?

• Learn by manipulating objects

• Think more flexibly

• Increased attention span

• Better problem-solving abilities

• Reversibility

• Conservation

• Classification of objects

• Metalinguistic awareness

• Language (vocab expands, reading efficiency improves)

What does the concrete operational stage look like in school age children?

Reversibility

Can mentally retrace a process

Conservation

Properties of objects don’t change

Metalinguistic awareness

Understand nuances of word/languages; humor and metaphors

Industry vs. Inferiority

What stage of Erikson’s psychosocial development are school age children in?

• Success in PERSONAL/SOCIAL/ATHLETIC tasks and outside activities is their “WORK”

• SELF-ESTEEM and PEER group identification is important

• Prefer activities with FRIENDS over family; family influence diminishes and conflicts may develop

What does industry vs. inferiority look like in school age children?

Pain, death, changes to body (disability)

What are the hospital fears of school age children?

Latency stage

What stage of Freud’s psychosocial development are school age children in?

Time of tranquility in sexual development; focused on activites that develop social/cognative skills

What does latency stage look like in school age children?

Conventional stage

• Stage 3

• Stage 4

What stage of Kohlberg’s psychosocial development are school age children in?

Younger age 6-10

What are the ages of stage 3 conventional stage of Kohlberg?

• Follow the rules to be viewed as "BEING GOOD”; behavior is right or wrong

• Understand the impact of their actions on others and can EMPATHIZE with others

What does stage 3 of the conventional stage (Kohlberg) look like for school age children?

Older school age 11-12

What are the ages of stage 4 conventional stage of Kohlberg?

“Law and order”, have rules and EXPECT them to be followed (call someone out for breaking rules)

• Action judged on INTENT rather than just OUTCOMES

What does stage 4 of the conventional stage (Kohlberg) look like for school age children?

Obesity; eating DO can begin at this age

What does nutrition look like for school age children?

Braces a focus

What does dental care look like for school age children?

• Younger: 12 hours

• Older: 10 hours

What does sleep look like for school age children?

Sports, board games, TV, video games, computers, bike, skating, hobbies

What do activities look like for school age children?

• Children want and expect limits on behavior

• FIRM, CONSISTENT limits and CLEAR expectations increase security and reinforce that they are cared about

• Children become ACCOUNTABLE for their actions

• Effective discipline separates the deed from the doer

  • Punishment can be mutually decided

• Positive acknowledgment of positive behaviors is effective in promoting good behaviors

What does discipline look like for school age children?

True (T)

T or F:

At school age, punishment may be mutally decided

School age

At what age do children become accountable for their actions?

• Stealing, lying, cheating may occur

• with PEER PRESSURE and may present a challenge

What bad behavior might occur during school age?

• Car, bike, PEDESTRIAN and sports safety

• Water safety

• School refusal (underlying problem like bullying, anxiety, depression)

• BULLYING

• SUICIDE

• Self care children (perform some activities independently, take care of selves)

• Fire and burns

• Gun

What is the safety concerns for school age children?

Bullying

What happens in 20% of middle school kids that might be a safety concern in school and can lead to children refusing school?

13-18 years

What is the age range for adolescents?

• Early: 13-14

• Mid-teens: 15-17

• Late: 18+

What are the stages of adolescence?

• RAPID GROWTH and dramatic changes, second only to infancy

• Development of secondary sexual characteristics and reproductive maturity (Tanner 3-5)

• Sexual orientation and gender identity

• OSSIFICATION of BONES (Tanner 5)

• VARYING levels of identity formation and emotional maturity (assess individually)

What does physical growth look like in adolescents?

• Increased endurance

• Increased speed and accuracy

What does GROSS motor development look like in adolescents?

• Computer skills

• Refined dexterity

What does FINE motor development look like in adolescents?

• Vocab expand

• Electronic communications has impacted language communication

What does language development look like in adolescents?

Formal operations stage

What stage of Piaget’s cognitive development are adolescents in?

Egocentric (everything about them), with limited abstract thinking

What does the formal operations stage look like for early teens (13-14)?

• Idealistic and introspective, thinking all about me

• Feel omnipotent and invincible, which leads to RISK TAKING BEHAVIORS

Idealistic, Introspective, Invincible

What does the formal operations stage look like for mid teens (15-17)?

• Develop REAL ABSTRACT and CRITICAL thinking skills

• Start to think about future plan and goals (long term consequences)

What does the formal operations stage look like for late teens (18+)?

Identity vs. Role Confusion

What stage of Erikson’s psychosocial development are adolescents in?

• Self concept

• Focus on body changes and body image

• Importance of PEER CULTURE becomes most important

• Relationship with parents can be challenging

• Colloquial speech (slang)

• Dating, sexuality, and leaving home

What identity vs. role confusion look like for adolescents?

• Increased independence

• Less parental influence (may align with or not)

Why might the relationship with parents be challenging with adolescents?

Genital stage

What stage of Freud’s psychosocial development are adolescents in?

Hormonal changes and sexual maturation are happening as teens are developing their sexual identity

• Focused on dating, romantic, or sexual relationships

What does the genital stage in adolescents look like?

Postconventional stage

What stage of Kohlberg’s psychosocial development are adolescents in?

• Start to INTERNALIZE their own values and moral code

• Develop a societal or “prosocial” awareness; start to understand the idea of GREATEST GOOD for the greatest number

• Learn to evaluate the morals of others

What does postconventional stage look like for adolescents?

• Well visits are important

• Nutritional needs

• Personal hygiene, dental care, sleep

• Piercings and tattoos (educate safety)

• Tanning; risk for SUN CANCER

• MENTAL AND SEXUAL HEALTH

What are the things to consider for adolescent health?

• Calcium, zinc, and iron

• Weight related DO

What are the nutritional needs of adolescents?

Mental and sexual health

What should you assess separately from parents with adolescents?

• Car safety

• Water safety

• Sexual activity (STI/HIV screening, pregnancy risk/contraception)

• Substance abuse

  • Alcohol

  • Marijuana and other drugs

  • Tabacco/vaping

• Violence

  • SUICIDE

  • Homicide/gangs

  • Firearms

  • Dating violence

What are the safety issues in adolescents?

• Sexual interest in opposite/same-sex partners is part of development

• Teens need to understand these new feelings and learn how to manage them in an appropriate way

• Teens for identify as LGBTQ+ are at an increased RISK FOR SUICIDE, HOMELESSNESS, VICTIMIZATION, and SUBSTANCE ABUSE

• Parents may need support in these conversations

What is the sexual health in adolescents?

Open, non-judgemental, respectful and build upon candor and trust

How should you approach discussion about sexual health in adolescents?

• Depression or other mental illness

• Poor impulse control/conduct DO

• Dysfunctional or disorganized family

• Substance abuse

• Significant changes in behavior (giving away valued possessions, worsening of school performance)

• Difficulties with sexual activity

• Social isolated (loner, victim of bullying)

• Recet stress

What are the risk factors for suicide?

• Allowing SUFFICIENT TIME for conversation

• SPEAK RESPECTFULLY as you would to a colleague

• Take FACE TO FACE, be aware of BODY LANGUAGE

• Ask OPEN ENDED questions to clarify and promote understanding

• REFLECT BACK what you think you heard so that he or she feels understood

• BE HONEST; don’t be afriad to say you don’t know

• BE LIBERAL WITH PRAISE; acknowledge effort

• Solicit the teen’s INPUT in decision making as often as possible

• Clearly state EXPECTATIONS and set LIMITS fairly

How do you improve communication with teens/adolescents?