 They appear taller and thinner

than toddlers because children

tend to grow more in height
than in weight.
 The preschooler’s brain almost
reaches its adult size by 5
years.
 The extremities of the body
grow more quickly than the
body trunk.
 The posture of preschoolers
gradually changes as the
pelvis is straightened and the
abdominal muscles become
stronger. They appear slender
with erect posture.
Weight:
 Weight gain in preschool children is generally slow.
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
somewhere between18 and 20 kg (40 and 45 lb)

Height:
 Preschool children grow about 5 to 6.25 cm (2.0 to
2.5in.) each year. Thus by 5 year of age they double
the birth length and measure 100cm (40in.).
Vision:

 Preschool children are generally hyperopic

(farsighted), that is unable to focus on near
objects.
 As the eye grows in length, it becomes
emmetropic (it refracts light normally).
 If the eyes become too long, the child
becomes myopic (nearsighted), that is
unable to focus on objects that are far away.
 Normal vision for the 5-year-old is
approximately 20/30.
Hearing and Taste:

 The hearing of the preschool child

has reached optimal levels, and the
ability to listen has matured since the
toddler age.
 For the sense of taste, preschoolers
show their preferences by asking for
something “yummy”, and may refuse
something they consider “yucky”
Motor Abilities:
 By 5 years of age, children
are able to wash their
hands and face and brush
their teeth.
 They are self-conscious
about exposing their
bodies and go to the
bathroom without telling
others.
 They run skillfully and can
jump three steps, they can
balance on their and dress
themselves without
assistance.
(Eric Erikson)
Initiative versus Guilt
 Preschoolers must solve problems in
accordance with their consciences.
Erikson views the crises at this time as
important for the development of the
individual’s self-concept.
 Preschoolers must learn what they can
do. As a result, preschoolers imitate
behavior, and their imaginations and
creativity become lively.
 Parents can enhance the self-concept of
the preschooler by providing
opportunities for new achievements
where the child can learn, repeat, and
master.
 The self-concept of the preschooler is
also based on gender identification.
Preschoolers are aware of the two sexes
and identify with correct one. They often
imitate sexual stereotypes and usually
begin by identifying with the parent of
the same sex.
 They may mimic the parent’s behavior,
attitudes, and appearance.
(Freud)
Phallic Stage of Development

 The biologic focus of the child

during this day is the genital
area.
 The phase of close emotional
relationships with both parents’
changes to the phase Freud
referred to as the Electra and
Oedipus complex.
 The child focuses feelings of
love chiefly on the parent of the
opposite sex, and the parent of
the same sex may receive
some hostile feelings.
 The child begins to develop
sexual interest and becomes
interested in clothes and hair
styles.
Sexual Curiosity

 When guiding parents concerning the sexual education

of young children, the nurse should use the following
principles of teaching

 First assess the knowledge base of the child

 Be honest and accurate in providing information at the
child’s level
 Use correct terminology so that misinformation or
misinterpretation can be avoided
 Provide sex education at the time the child asks the
question
 Parents must understand that sexual curiosity starts as
an inquiry into anatomical differences`
Masturbation

 Masturbation is common in both genders during

the preschool years
 The child experiences pleasurable sensations
which lead to a repetition of the behavior
 Masturbation in the preschool child is considered
harmless if the child is outgoing, sociable and
not preoccupied with the activity
 Education of the parents consists of assuring
them that this behavior is a form of curiosity and
is normal and not harmful to the child
Four Adaptive Mechanisms

 Identification – occurs when the child perceives the self

as similar to another person and behaves like that
person.
 Introjection – is similar to identification. It is the
assimilation of the attributes of others. When
preschoolers observe their parents, they assimilate
many of their values and attitudes.
 Imagination – is an important part of preschooler’s
lives. The preschooler has an active imagination and
fantasizes in play.
 Repression – is removing experiences, thoughts, and
impulses from awareness.
The Three Year Old

 They are helpful and can

assist in simple chores
 Temper tantrums are less
frequent
 They can help dress and
undress themselves
 They eat independently
and table manners have
improved
 Can talk in longer
sentences and can express
thoughts and ask questions
 Parallel play (playing
independently within a
group) and associative play
are typical of this age
period
The Four Year Old
 The four year olds are more
aggressive and like to show off
newly refined motor skills
 Four year olds are boisterous,
tattle on others, and may begin
to swear if they are around
children or adults who use
profanity
 At this age children become
interested in how old they are
and want to know the exact age
of each playmate
 Four year olds can use scissors
with success
 There vocabulary has increased
to about 1500 words
 Raw materials are more
appealing to a four year old then
toys that are already made
The Five Year Old

 The five year old is more

responsible, enjoy doing what is
expected of them, have more
patients and like to finish what
they started
 They talk constantly and are
inquisitive about their
environment
 There height may increase by 2
to 3 inches, and may gain 3 to 6
pounds
 They may begin to lose their
deciduous teeth at this time
 They can usually print there
first name
 At the age of 3 or 4, they learn to play with a small number of their
peers. They gradually learn to play with more people as they grow
older.
 In their speech, children of 4 years are often dogmatic; they tend
to believe that what they know is right.
 At 4, Children are aggressive in their speech and capable of long
conversations, often mixing fact and fiction. By 5 years of age,
speaking skills are well-developed.
 They play with their bodies largely out of curiosity. They know
where the body begins and ends as well as the correct names for
the different parts.
 Preschoolers learn about their feelings. They also begin to learn
how to control their feelings and behavior.
 They are interested in seeing new places and enjoy going with
the family on vacation- these activities lead to increased
vocabulary and learn words which they transfer from abstract
concepts to the objects to which they relate.
Types of Play

 Preschool children need

playmates to promote social
development
 The Preschool child gradually
moves from parallel and
associative play to cooperative
play with playmates
 Play should be noncompetitive
and supervised for safety
 Imaginary friends are common
in the preschool age
They serve to help the
child adjust to an expanding
world and increased
independence
 Some suitable toys for the
preschooler are large
construction sets, number or
alphabet games, play tools,
large puzzles and clay
 Active play can include simple
climbing, sliding and running
Preparing for a new sibling

 Introduction of a new sibling is

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

SIBLING RIVALRY:
 jealousy of a brother or sister
may first become evident during
this period, partly because they
have enough vocabulary to
express how they feel.
(Piaget)
Phase of Intuitive Thought

 Children are egocentric. But egocentrism gradually

subsides as they experience their expanding world.
 Preschoolers learn through trial and error, and they think
of only one idea at a time.
 The child with a well-developed sense of initiative
discovers that learning about new things is fun
 They do not understand relationships such as those
Reading skills also start to develop at this age. Young
children like fairy tales and books about animals and other
children
(Kohlberg)

 Preschoolers are capable of prosocial behavior, that is, any

action that a person takes to benefit someone else.
 Prosocial – is synonymous with kind and connotes
sharing, helping, protecting, giving
aid, befriending, showing affection, and giving
encouragement.
 Preschoolers do not have a fully formed conscience;
however, they do develop some internal controls. Moral
behavior is largely learned by modeling, initially after
parents and later significant others.
 Preschoolers usually control their behavior because they
want love and approval from their parents.
 It is important for parents to answer preschoolers’ “why”
questions and discuss values with them.
(Fowler)

 Children ages of 4 to
6 years are at the
intuitive-projective
stage of spiritual
development.
 Faith at this stage is
primarily a result of
the teaching of
significant others,
such as parents and
teachers. They learn
to imitate religious
behavior.
 Children at this age
use their imaginations
to envision such ideas
as angels or the devil.
 Respiratory tract
problems and
communicable diseases
frequently occur as the
preschooler interacts
with other children at
nursery schools and day
care.
 Accidents and dental
caries are problems
during this age.
 Congenital
abnormalities such as
cardiac disorders and
hernias are often
corrected at this age.
Accident Prevention

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

 There injury may be related to a bad fall since preschool
children hurry up and down stairs, they play hard with
there toys and like to climb and stand on things
 When buying toys for the preschooler make sure they are
sturdy and age appropriate
 Automobiles are threat, child should be taught where
they can ride there bike and play with a ball
 Never leave the child alone in or around a car
 Burns at this age usually occur from children
experimenting with matches
Safety

 Burn from hot coffee are also common

 These things should be kept high and out of reach from the
child
 There dangers should also be explained to the child
 Poisoning is also a danger since children in this age group try to
imitate adults and are apt to sample pills
 Preschool children should also be taught the dangers of talking
to or accepting rides from strangers
 Parents should make it clear to children in nursery school that
they will never send a stranger to pick them up
 They should also be warned about the dangers of playing in
places alone and accepting gifts from strangers
Preschooler development on daily
activities

 Preschoolers have often mastered the

basic skills needed for most self-care
activities including feeding, dressing,
washing and tooth brushing

 DRESSING: most of them can dress

themselves except for difficult buttons,
although there may be a conflict with
what the child would wear

 SLEEP: they are aware of their heeds,

when they are tired, they often curl up on
the sofa or bed and fall asleep

 EXERCISE: this period is an active phase

so they make a great deal of exercise
 BATHING: they can wash and dry their
hands perfectly adequately if the faucet is
regulated for them

 CARE OF TEETH: the child should

continue drinking fluorinated water or
receive a prescribed oral fluoride
supplement if fluoride is not provided
in the water supply; one good tooth
brushing session a day is more often
effective than more frequent half-
hearted brushings
Bedtime Habits

 Parents should engage the child in quiet

activities before bedtime
 Storytelling
 Attention getting behavior that results in taking
the child into the parents bedroom should be
discouraged because it rewards bad behavior
and defeats the purpose of bedtime rituals
Health Examinations
 Every 1 to 2 years

Protective Measures
 Immunizations: continuing DPT, OPV series, MMR,
hepatitis, and other immunizations as recommended.
 Screening for tuberculosis.
 Vision and hearing screening.
 Regular dental screenings and fluoride treatment.

Preschooler Safety
 Educating child about simple safety rules.
 Teaching child to play safely.
 Educating to prevent poisoning.
Nutrition
 Importance of nutritious meals and snacks.

Elimination
 Teaching proper hygiene.

Rest/Sleep
 Dealing with sleep disturbances.

Play
 Providing times for group play activities.
 Teaching child simple games that require
cooperation and interaction.
 Providing toys and dress-ups for role-playing.