PRESCH

OOL
PERIOD

 The preschool period traditionally

includes the years 3, 4, and 5.
Physical growth is slow while
personality and cognitive growth
continue at a rapid rate.
It is also an important stage for
parents because they may be
unsure how much independence
and responsibility for self-care they
should allow their rapidly maturing
child.

Most of the children at this age

wants
to
do
things
for
themselves:
Choose their own clothing and
dress themselves
Feed themselves completely
Wash their own hair and so
forth

Physical Growth
Definite changes in body contour occurs
during the preschool years
The wide-legged gait, prominent lordosis
and protuberant abdomen of the toddler
change to slimmer, taller and much more
childlike proportions.
Contour changes are so definite that future
body type ectomorphic body built (slim
body built) or endomorphic body built
(large body built)becomes apparent.

Handedness also begins to be obvious

Childs ability to learn extended language, which is achieved not
only by motor development but also by cognitive development.
Lymphatic tissue begins to increase in size, particularly the
tonsils; level of immune globulins IgG and IgA antibody increase.
These changes tend to make preschool illnesses more localized.
(eg. An URI remains localized to the nose with little systematic
fever)
Physiologic splitting of the heart sounds may be present for the
first time on auscultations; innocent heart murmurs may also be
heard for the first time. This type of murmurs occurs because of
the changing size of the heart in reference to the thorax because
the anteroposterior and transverse diameters of the chest have
not yet reached adult proportions.
Pulse rate decreases to about 85 beats.min and blood pressure
holds at about 100/60 mmHg
Many children at the beginning of the period exhibit genu
vulgus (knock-knees); this disappears with increased skeletal

Weight, height, body mass

index and head circumference
Weight gain is slight during the
preschool years; the average child
gains only about 4.5 lb (2 KG) a year
Height gain is also minimal during this
period; only 2 or 3.5 in ( 6 - 8 cm ) a
year on average.

Teeth
Children generally have all 20 of their
deciduous teeth by 3 years of age;
permanent teeth dont replace these
until school age. Preserving these
teeth is important because they hold
the position for the permanent teeth
as the childs jaw grows larger.

AGE

Developmental
Milestones
FINE MOTOR
GROSS
LANGUAGE
SKILLS

MOTOR
SKILLS

UNDRESSES
SELF; STACKS
TOWER OF
BLOCKS;
DRAWS A
CROSS

RUNS;
ALTERNATE
FEET ON
STAIRS; RIDE
TRICYCLE;
STANDS ON
ONE FOOT

VOCABULA
RY OF 900
WORDS

PLAY

ABLE TO
TAKE
TURNS,
VERY
IMAGINAT
IVE

CAN DO SIMPLE CONSTANTLY VOCABULA PRETENDI

BUTTON
IN MOTION; RY OF 1500
NG IS
JUMPS;
WORDS
MAJOR
SKIPS
ACTIVITY
CAN DRAW A
SIX PART
FIGURE; CAN
LACE SHOES

THROWS
OVERHEAD

VOCABULA
RY OF 2100
WORDS

LIKES
GAMES
WITH
NUMBERS
OR

Emotional Development

Initiative
Imitation
Fantasy
Oedipus and Electra Complexes
Gender Roles
Socialization

Initiative
The developmental task for the preschool age child is to
achieve a sense of initiative versus guilt ( Erikson, 1993)
Children with a well developed sense of initiative like to
explore because they have discovered that learning new
things is fun
if children are criticized or punished for attempts at
initiative, they can develop a sense of guilt for wanting to
try new activities or new experience
To gain sense of initiative, preschooler need exposure to
a wide variety of experience and play materials so they can
learn as much as about how things work as possible. They
are ready to explore outside their homes such as enjoying a
trip to a zoo or an amusement park . They enjoy going to a
family vacation. These types of enjoyment could lead to
increases vocabulary

Imitation
Imitating the actions of the people
around them peaks during preschool
age.
Role modeling this way should be fun
and does not have to be accurate
Children generally imitate those
activities best that they see their
parents performing at home.

Fantasy
Toddlers cannot differentiate between fantasy
and reality; they believe cartoon characters
they see on television are real. Preschoolers,
however, begin to make this differentiation
They may become so engrossed in a fantasy
role, however that they become afraid they
seem to have their own identity or become
stuck in the fantasy. Such as intense
involvement in play is part of magical
thinking, which is active at this age

Oedipus and Electra

Complexes

Although the development of Oedipus and

Electra complexes may have been overrated
by Freud, possibly because of gender bias
may children do appear to manifest such
behavior (Erreich, 2011)
Oedipus complex refers to the strong
emotional attachment a preschool boy
demonstrates towards his mother
Electra Complex is the attachment of a
preschool girl to her father

Gender Roles
Preschoolers begin to be aware of
the difference between sexes and so
need to be introduced to bother
gender roles

Socialization

3 years olds are capable of sharing, they play with other

children their age much more agreeably than to toddlers,
which makes the preschool period become a sensitive and
critical time for socialization. Preschoolers who are exposed
to other playmates have an easier time learning to relate to
people than those raised in an environment where they
rarely see other children of same age (Paulus & Moore, 2012)
4 years old continue to enjoy play groups, they may become
involved in arguments more than they did at age of 3 years,
especially as they become more certain of their role in the
group.
5 years old begin to develop best friendships, perhaps on
the basis of who they walk to school with or who lives
closest to them.
The elementary rule that an odd number of children will have
difficulty playing well together generally pertains to children
at this age ;two or four will play but three or five will quarrel.

Cognitive Development
According to piaget (1969) at 3 years of age,
cognitive development is still preoperational.
Although children during this period do enter a
second phase called intuitional thought, they
lack the insight to view themselves as others see
them or to put themselves in anothers place
(this is termed centering) because preschoolers
cannot make this kind of mental substitution,
they may always feels right.
Preschoolers are not aware of the property of
conservation, this inability to appreciate
conservation has implications for nursing care
because it means preschoolers are not able to

Moral and Spiritual

Development
Children of preschool age determines right from

wrong
based on their parents rule because they have little
understanding of the rationale for these rules or even
whether the rules are consistent.
Preschoolers begin to have an elemental concept of God if
they have been provided some form of religious training.
Belief in an outside force aids in the development of
conscience; however preschoolers tend to do good out of
self- interest rather than because of strong spiritual
motivation (kohlberg, 1984)
Children at this age enjoy the security of religious holidays
and religious rituals such as prayer and grace before meals
because these rituals offer them the same reassurance and
security as a familiar nursery rhyme read over and over.

Promoting Preschooler
Safety
As preschoolers broaden their horizons,

safety issues must also widen. By the

age of 4, children may project an
attitude of independence and a ability
to take care of their own needs.
They still need to be supervision to be
certain they do not injure themselves
or other children while roughhousing
and to ensure they do not stray too far
from home.
A final area to consider is automobile
safety. Preschoolers must be reminded

Keeping Children Safe, Strong

and Free

Preschool years are not too early a time to educate children about
the potential threat of harm from strangers or how to address
bullying behavior from people they meet at school or play (JonsonReid, Kohl & Drake, 2012) through such measures:
Cautioning child never to talk with or accept a ride from stranger
Teaching a child how to call for help in an emergency
Describing what police officers can help in an emergency situation
Explaining that if children or adults ask them to keep a secret
about anything that has made them uncomfortable, they should tell
their parents or another trusted adult, even if they have promised
to keep a secret
Explaining that bullying behavior from other children is not to be
tolerated and should be reported so they can receive help
managing it.

Motor vehicle and bicycle safety

Preschool is also the right age to
promote bicycle safety because falls
off bicycles are a major cause of
severe head injuries in this age group
(Agarwal & Pruthi, 2010)
To
prevent
such
injuries
,
preschoolers need a safety helmet
approved for children age and size.

Promoting the nutritional Health

of a Preschooler
Like toddler period, the preschool years are not a time
of fast growth , so preschool children are not likely to
have a ravenous appetites (Raman, 2011)
A sense of initiative or learning how to do things can
be strengthened by allowing a child to prepare simple
foods, such as making a sandwich or spreading a jelly
on a toast
Most children are hungry after preschool and enjoy a
snack when they arrive home. Because sugary foods
can dull a childs appetite for dinner and it is not too
soon to begin a measures to prevent childhood
obesity, urge parents to offer snack such as fruit,
cheese or milk rather than cookies and a soft drink or
juice (Bevan & Reilly, 2011)

Preschool Nutrition
Requirements
Preschoolers may not eat a great
deal of meat because it is hard to
chew. Many parents ask whether
their preschoolers to take
supplementary vitamins to make up
for this.
As long as a child is eating foods
from all five groups and meets the
criteria for a healthy child such as
being alert and active with height
and weight within normal averages,

Vegetarian Diet
Vegetarian diet is usually colorful and therefore
appeals to preschoolers. Vegetables, fruits and
grains are also healthy snack foods.
If vegetarian diet are deficient in any aspects, it is
usually in: calcium, Vitamin B and Vitamin D.
Check if a child is ingesting a variety of calcium
sources because calcium is very important for bone
growth.
Vitamin D is found in fortified cereals and milk
Vitamin B12 is found almost exclusively in animal
products.
So a child on a vegetarian intake may need a
supplemental source of this (whitney & rolfes 2013)

Promoting the Development of

the Preschooler in Daily Activities
The preschooler has often mastered
the basic skills needed for most selfcare activities, including
Feeding
Dressing
Wishing (with supervision)
Tooth brushing (with supervision)

Dressing
Many 3 or 4 years old can dress
themselves except for difficult buttons,
although there may be a conflict over what
the child will wear.
Preschoolers prefer bright colors or prints
and so may select items that are
appealing in color than matching

Sleep
Preschoolers are more aware of their needs;
when they are tired they often curl up on a
coach or soft chair and fall asleep
On some occasion even though they may tired
children in this age group may refuse to go to
sleep because of fear of dark and may wake at
night terrified by a bad dream. This means
preschoolers may need a night-light turned on.
Although they did not need one before

Exercise
A preschool age is an active phase so preschool play
tends to be vigorous.
Roughhousing helps relieve tension and should be
allowed as long as it does not become destructive
They also love time-honored games such as ring-around
the rosy, London bridge or other structured games they
were not ready for as toddlers.
Promoting these types of active games and reducing
television watching can be steps toward helping children,
develop motor skills as well as prevent childhood obesity

Hygiene
Preschoolers can wash and dry their hands
adequately if the faucet is regulated for
them.
Children this age are not paragons of
neatness and may not clean their hands
thoroughly. Preschoolers do not clean their
fingernails or ears as well, either so these
areas often need touching up by a parent
or older sibling.

Care of teeth

If independent tooth brushing was not started as a

daily practice during toddler years, it should be
started during preschool
Electronic or battery operated toothbrushes are
favorites of preschoolers and can be used safely if
the child is taught properly
Preschoolers should continue to drink fluoridated
water or receive a prescribed oral fluoride
supplement if fluoride is not provided in the water
supply
A first visit to a dentist should be arranged no later
than 3 years of age for an evaluation of tooth
formation because deciduous (baby ) teeth must
be preserved to protect dental teeth
Teeth grinding similar to body rocking which
children do for a short time each night before
falling asleep.

discipline
A time out is useful
technique for parents
to correct behavior
throughout
the
preschool
years,
should be as many
minutes long as the
child is old so 3 -5
minutes is appropriate
for preschoolers

Common fears of the

Preschooler
Fear of the Dark
Fear of Mutilation
Fear of separation or
abandonment

Behavior Variations

Telling tall tales

Imaginary friends
Difficulty sharing
Regression
Sibling rivalry

Sex education
During preschool age children become
acutely aware of the difference between
boys and girls, possibly because it is a
normal progression in development and
possibly because this may be the first time
they are exposed to the genitals of the
opposite sex as they watch while a new
brother or sister has a diaper changed.
They see other children using bathrooms
at a preschool or they see a parent nude

Choosing a Preschool or Child

Care Center
A school or child care experience is
helpful for preschoolers because peer
exposure appears to have a positive
effect on social development
The term child care center and
preschool are often interchangeably
so parent cannot depend on the
name of a school to define its
structure

 The main purpose of a child care

center is to provide child care while
parents work or are otherwise
occupied
A Preschool is dedicated to
stimulating
childrens
sense
of
creativity
and
initiative
and
introducing them to new experience
and social contacts that they would
not ordinarily receive at home.

Broken Fluency
Developing language is such a complicated
process that children from 2 to 6 years of age
typically have some speech difficulty.
A child may begin to repeat words or syllables
saying I-I-I want a n-new spoon-spoon-spoon
this is called broken fluency (repetition and
prolongation of sounds, syllables and words)
It is often referred to secondary stuttering
because child began to speak without this
problem and then, during this preschool years
develops it.