The Preschooler & Family Study Notes

The Preschooler & Family Study Notes

The Preschooler - The Stats

  • Age Range: 3-6 years
  • Average Weight Gain: 4-5 lbs per year (1.8-2.3 kg)
  • Average Height Increase: 2.5-3 inches per year (6.5-7.6 cm)

Organ System Maturation

  • General Maturation: Most body systems mature during this phase.
  • Bowel and Bladder Control: Improved control is noted.
  • Eustachian Tubes: Remain fairly straight and short, impacting ear health.
  • Heart Rate and Blood Pressure: Variability may be detected in measurements, including innocent murmurs and a split second heart sound (S2).
  • Teeth: Typically, 20 primary teeth are present by age three.
  • Bowel Movements: 1-2 bowel movements per day; urethra remains short, affecting urinary health.
  • Musculoskeletal System: Still not fully mature, leading to an increased risk of injury.

Sensory Development

  • Hearing: Improvement in auditory responses.
  • Smell, Touch, Taste: Increased sensitivity and skill in these areas.
  • Vision: Development advances significantly during these years.

Psychosocial Development (Erikson's Theory)

  • Stage: Initiative vs. Guilt (Ages 3-6 years)
  • Characteristics:
    • Inquisitive and enthusiastic about learning.
    • Develops a sense of accomplishment and pride (initiative).
    • Experiences guilt for breaking rules.
    • Development of the superego, forming the basis for moral development during this time.
Erikson's Specific Insights
  • Likes to please parents and begins to plan activities, make games, and initiate activities with peers.
  • Acts out various roles of both imaginary and real people.
  • Develops sexual identity and a conscience, feeling remorse when making wrong choices.
  • Enjoys exploring new activities such as sports, shopping, and cooking.
  • Engages in cooperative negotiations with other children regarding conflicts.

Cognitive Development (Piaget's Stages)

  • Preoperational Substages:
    • Preconceptual Phase (Ages 2-4):
    • Egocentric thinking, but begins to lessen around age 4.
    • Short attention span; learns through imitation and observation.
    • Displays animism (attributing human qualities to inanimate objects).
    • Forms incomplete concepts not as logical as adults.
    • Intuitive Phase (Ages 4-7):
    • Active imagination; understanding of opposites (e.g., hot vs. cold).
    • Classes objects and begins to relate them; able to recognize right from wrong without reasoning why.
    • Curiosity about facts and cultural rules, with increasing ability to classify and relate objects.

Moral & Spiritual Development

  • Moral Understanding: Very basic moral framework based on rules and associated punishments (preconventional stage).
  • Dealing With Feelings: Children learn to cope with feelings, which may not be appropriately expressed.
  • Spiritual Learning: Typically influenced by family; includes understanding and memorizing simple Bible stories and prayers, linked to the development of conscience.
  • Religious Influences: These beliefs may affect diet, upbringing, and parent-child dynamics.

Kohlberg's Moral Development

  • Focus: Punishment-obedience orientation (Age 2-7 years).
  • Morality: Good vs. bad is determined by the associated punishment. Children may adopt inappropriate behaviors if not correctly addressed by parents.

Motor Skills Development (Fine & Gross)

  • Gross Motor Skills by Age:
    • 3 Years: Climbs, pedals a tricycle, runs easily, performs basic climbing, and throws a ball.
    • 4 Years: Hops, swings, climbs well, may skip, and can somersault.
    • 5 Years: May learn to skate and swim, stands on one foot for longer durations (10 seconds), and performs more complex movements.
  • Fine Motor Skills by Age:
    • 3 Years: Uses a fork, builds towers, strings beads, copies simple shapes.
    • 4 Years: Uses scissors, copies letters, and draws basic shapes.
    • 5 Years: Fastens buttons, draws more detailed figures, and demonstrates better hand control and coordination.

Communication/Language Development

  • Language Acquisition:
    • 3-year-olds typically have a vocabulary of around 900 words.
    • 5-year-olds increase vocabulary to approximately 2,100 words and may learn 10-20 new words daily.
  • Communication Style: Initially telegraphic, evolving towards more complete sentences with adults, elaboration in storytelling, and increasingly complex conversations.
  • Bilingual Children: May experience slight delays in vocabulary acquisition.

Body Image and Social Awareness

  • Body Image: Preschoolers start to notice societal standards of beauty and their own body boundaries.
  • Social Dynamics: Separation anxiety decreases; children can part from caregivers with greater ease.

Emotional/Social Development

  • Emotional Intelligence: Children experience strong emotions, develop a sense of identity, and understand the importance of rules and boundaries.
  • Social Curiosity: Children become curious about gender differences and questions about where babies come from.

Friendships

  • Importance of Friendships: Developing friendships outside the family becomes crucial, impacting social skills and behavior.
  • Peer Influence: Kids may conform to peer rules to maintain friendships but can also face disagreements.

Temperament

  • Influence on Behavior: A child’s temperament greatly affects reactions to situations. Traits include adaptability, reactivity, and the capacity for self-control.

Fears

  • Common Fears: Include fear of the dark, loneliness, certain animals, and strangers. Involving children in handling fears can be beneficial.

Cultural Influences

  • Learning Prejudice and Bias: Cultural context affects children’s views on education and may influence their dietary preferences.

Nursing Role in Growth and Development

  • Health Visits: Focus on anticipatory guidance regarding growth and development (G&D) needs and preparing for school.
  • Hospitalized Children: Must still have their G&D needs met even in healthcare settings.

Promoting Healthy Growth and Development

  • Building Self-Esteem: Engaging children in activities that enhance self-worth.
  • Importance of Routines: Establishing clear expectations, setting limits consistently, and monitoring developmental norms are critical.

Signs of Developmental Delay (TABLE 27.4)

  • At Age 4:
    • Cannot jump in place or ride a tricycle.
    • Cannot stack four blocks; difficulties with ball throwing or holding crayons.
  • At Age 5:
    • Cannot use appropriate pronouns or engage with others; resistant to toilet training or dressing independently.

Promoting Growth & Development Through Play

  • Preferred Play Types: Creative, cooperative, imitative, and imaginary play types foster development.

Appropriate Toys for Preschoolers (BOX 27.1)

  • Recommended Play Items: Blocks, simple puzzles, supplies for creative projects such as coloring materials and dolls for role-playing.

Early Learning and Language Promotion

  • Role of Parents: Parents as first teachers should foster positive learning environments and encourage exploration through storytelling and engagement without excessive correction.

Choosing a School

  • Considerations: Parents need to assess various factors such as accreditation, teacher qualifications, and environments conducive to social skill development.

Starting Kindergarten

  • Preparation Tips for Parents: Cultivating excitement and familiarity with routines, ensuring immunizations are up to date, and engaging positively with teachers.

Promoting Safety

  • Safety Concerns: Preschoolers are at risk of accidents; thus, supervision is essential. Teach them safe behaviors while acknowledging that they may not recognize danger effectively.

Car Safety

  • Car Seat Requirements: Under age 4—require forward-facing seats; after age 4, children should use booster seats until they reach 4 feet 9 inches in height.

Home Safety

  • Awareness of Risks: Address common dangers at home including smoke exposure, bicycle safety, and storage of hazardous substances.

Promoting Nutrition

  • Nutritional Guidelines: Recommend daily intake for calcium (700-1000 mg) and iron (7-10 mg) to support healthy growth.

Preventing Obesity

  • Rising Concern: Noteworthy increase in childhood obesity rates; requires structured, positive mealtimes focusing on healthy choices without pressuring children to eat.

Promoting Healthy Sleep & Rest

  • Sleep Requirements: Preschoolers need 10-13 hours of sleep and may experience infrequent naps; recommended bedtime routines are crucial for encouraging healthy sleep habits.

Sleep Problems

  • Assessment Needs: Nightmares and night terrors require distinct handling strategies based on their behavioral characteristics.

Promoting Healthy Teeth & Gums

  • Dental Care Practices: Regular professional dental visits, fluoride applications, and teaching children proper dental hygiene routines are vital.

Promoting Appropriate Discipline

  • Discipline Strategies: Encourage clear limits and recognize good behavior positively, avoiding punitive measures that damage self-esteem.

Addressing Common Developmental Concerns

  • Lying: Normalize the behavior, explore reasons behind it, and set examples of honesty.
  • Sex Education and Masturbation: Approach these sensitive topics with honesty and factual information, maintaining open communication with children.