Preschooler Growth and Developmental Milestones Nursing Review

Preschooler growth and development milestones review for nursing students!

For pediatric nursing class, you must be familiar with all the growth and development milestones for each age group. This review will discuss the growth and development for the PRESCHOOLER. After you review this material, don’t forget to take the preschooler growth and development quiz.

Don’t forget to check out the other reviews:

• Infant
• Toddler

Preschooler Growth and Development Nursing Review

The preschooler includes the ages 3-5 years, and to help us remember the main concepts about the preschooler, let’s remember the word “preschool”.

Physical changes

The preschooler is going through the process of stretching and filling out. Their face is becoming more defined (less round) and they’re losing the protruding belly. In addition, their limbs are elongating. By the end of preschoolerhood, at the age of 5, the child will be social, talkative, and very active with a blossoming personality.

• Gaining only about 5 lbs/yr and grows about 3 inches per year
• Height average: 44 inches (by 5 years)
• Weight average: 42 lbs. (by 5 years)

Fine and gross motor skill development is rapidly becoming fine-tuned from the age of 3 to 5.

Gross motor skill examples:  ride a tricycle, catch and bounce a ball, run, hop, skip, climb etc. and all of these skills are becoming very well established as he or she approaches 5.

Fine motor skill examples (by the age of 5): copy and write first name, zip-up jacket, button-up shirt, use scissors, copy shapes like triangle, circles…all of these skills are getting the child ready for school.

Reduced Separation Anxiety (but still there until around 4 to 5 years): the young preschooler (age 3) does not like being away from the parent, especially during a stressful situation, sickness, etc.

• The young preschooler tolerates it better than the toddler during the protest stage in that he or she will not scream and cry loudly, but instead they will cry quietly and may act out.
• The despair and detachment stage of separation anxiety is the same as the toddler.
• Magically thinker: may think the parent may be hurt or never coming back when separated from the parent….they don’t understand time (so don’t give a time for when coming back….just reassure them frequently the parent is coming back)

Erickson and Piaget’s Theories

Initiative vs. guilt: third stage and it’s from ages 3 to 5

• The child gained the sense of trust and developed autonomy in the previous two stages. Now they need independence to try new things, learn how to accomplish tasks, make decisions, and how to deal with situations that challenge them ex: failure, making right choices (conscience is developed…choosing right or wrong…will they choose to obey?).
  • If not given opportunities to try new things or make choices by self the child will develop guilt and struggle with trying new things and struggle with being independent….will have issues with developing a sense of purpose.
  • If this stage is failed, they will experience guilt.
  • If this stage is accomplished, the child will have a sense of purpose.
  • Interventions to help the child in this stage:
    • Encouraging play, especially imaginary play, giving the child within reason freedom to try new things and encouraging them when they fail, avoid criticizing or trying to control all aspects of choices and try to accept their choices

Piaget’s Theory:

Preoperational: 2-7 years and overlaps with the toddler in the previous lecture

• The preschooler is egocentric still like the toddler but are changing to eventually be able to see things for other people’s point of view (currently they see things from their point of view only).
• They’re magical thinkers and love pretend play (having imaginary playmates etc.)
• Animism: the preschooler thinks inanimate objects (ex: toys) are living things and have feelings like they do….example: my son had a stuffed monkey and when he would eat, he would have to feed the monkey because it was hungry too.
• Literal thinkers

Scared of things “FEAR”

Preschoolers fear many things due to their inability to distinguish fact from fiction and their creative imaginations fuel this fear.

• Animism (discussed above) can cause fear. Toys that are scary looking or make loud noises can cause this. The YouTube lecture contains a real life example of a preschooler experiencing fear due to animism.
• Hospitalizations: feel like they are sick because of something they did and the hospitalization/sickness is punishment…reassure them this is not the case but they have a sickness and be honest with them about it…explain in very simple terms.
• Procedures: the preschooler fears mutilation of their body and that they may lose something on their body. This is especially true since they are very creative thinkers and make the procedure worst than it really is. They most definitely fear invasive procedures like shots, IVs, etc.
  • Interventions and education to help them cope:
    • simple explanations, medical play: dolls (demonstrate how to give a shot and let them do it, read a book about it), listen to the child and answer their questions, keep parent with them if possible, give choices, allow to be independent (regression can still happen when stressed or experience loss of control), avoid giving a specific time but in relation to an event or in stages as it’s about to happen….example: “Your friend will visit after your afternoon nap.”….don’t say “At 1 o’clock your friend will be here.”

Child Safety: not as rambunctious and unaware of danger compared to the toddler because the preschooler has now developed more intellect and can follow the rules, but still have to watch with other things like: unsecured guns, swimming, bike safety, stranger danger etc.

Healthy eating: not as picky as the toddler, especially by five…more willing to try new foods and be better at sitting down to eat as they approach 5 (younger children will still not be able to sit for long periods)

• “baby teeth” completely in by 3 (dental care very important)…start losing them around 5 to 6 (varies from child to child)….avoid fatty, sugary foods
• always watch for choking risk….don’t run with suckers in mouth or talk with food in mouth etc.

Others are starting to become important for playtime…finally starting to transition where they want to play with others…starts out with associative play…then cooperative play

Play style:  associate play (starting around 3 years…progressed from parallel play by the toddler) to cooperative play (around 4-5 years).

• Associative play: children are playing/talking together in the sense they are doing the same activity together like using the same toys (where they begin to understand sharing or borrowing) or using the same equipment
  • example: playing in a sand box by using shoves and sand molds but they aren’t working together to accomplish something but rather focusing on their own activity…..this type of play is building the framework for social interaction and how to get along with others…hence cooperate
• Cooperative play: children play together doing the same activity by cooperating and collaborating together and have the same focus and goals doing so…..ex: working together to build a sand castle…they must communicate with peers, follow the rules, be kind, share, leader and follower easily seen.

Outline behavior expectations for the parent during this age range:

• Can experience loss of control due to being hospitalized or sick. This occurs because they can’t do the things they normally did like dress, eat, play.
• Due to this loss of control, the child can regress.
• Aggression in behavior: can be influenced by parents “modeling” or other aggressive people in the child’s life, media
• Negativism and ritualism like during the toddler years is decreasing
• Can experience nightmares (reassure them that you’re there, listen, help go back to own bed)

Language explosion: major development in language during this time….vocabulary exploding by age of 5 in that they know about 2400 words and speak in 5 word sentences that are complex with descriptive words and use conjunctions like and or but to join words together.

• May experience stuttering during this time but should resolve after the age of 5.
• If child does this: take time to listen, don’t rush them or finish their words or sentence or scold or make fun of the child for this issue or make a big deal about it…. referral for speech therapy may be needed to prevent problems as he or she becomes older and still stutters.

References: