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Preschooler Psychosocial and Behavioral Development

Family Relationships

Evidence during the visit: Any tantrums and how parent manages them. Reaction to fears related to the visit and how parents manage. Ability of the child to pay attention to instructions and interview questions during the visit. Ability to

"Behavior around others" is comprised of the quality of relationships, social skills and emotional development, temperament, family discipline, biologically determined behavioral predispositions, and contextual stresses and supports. Controlling emotional states, including delaying gratification and tolerating frustration, separations, and fears without breaking down emotionally, are

SEPARATION

Tolerating separation from the parents is necessary to the growing autonomy of the child that is characteristic of this period. After the initial developmental task of forming attachments to their primary caregivers over the first 2 years, children now must hold the security of those relationships in

EMOTIONAL TONE

Beyond the most common factor of temperament, children develop their emotional tone in several ways. The pattern of secure attachment to primary caregivers in infancy has some predictive power for "joy in mastery," "sociability," and IQ in the preschooler. Children younger than age 6 are

FEARS AND FANTASIES

Fantasy life becomes very rich during the preschool years. At first, it is indistinguishable from reality, resulting in a tendency for fears. By the age of 4, children frequently have frightening dreams that they can state are "not real," although this does not necessarily reassure them. Excessive fears

TANTRUMS

Temper tantrums are so common as to be characteristic of 2-year-olds, but they should be infrequent by age 5, although there is another peak at 6 years, perhaps in response to the greater stresses of formal academic schooling. Temper tantrums can be exacerbated by: reinforcement by the parents; modeling in the family; exposure to violence, including physical punishment; temperamental low threshold, high reactivity, or lack of adaptability; fatigue; hunger; and lack of routines. Breath-holding spells may follow a tantrum. They occur in 5% of children younger than

OPPOSITIONALITY

Evidence during the visit: How does the parent set limits on exploration of the room, their possessions, their bodies, and excessive silliness or talking? Observations of the parents' limit-setting on siblings. Do parents interfere with each other's management in the room? Do parents hit the child in the waiting room or

Almost all preschool children are noncompliant, at least some of the time--on average, they comply with adult requests about 50% of the time. This struggle for autonomy can be viewed as a positive milestone of development, with passivity representing a potential symptom of depression or intimidation. It is the parents' job to provide the structure that will influence the child to comply with our culture's standards for behavior. Research indicates that parents who are

One major concern of parents of preschoolers that affects both the relationship and the child's compliance is his or her activity level. Sturner found that 25.3% of parents of 4-year-olds included "overactive" in a checklist of adjectives about their child. However, poor control of attention is a greater detriment to academic success than high activity level. Multiple factors affect the attentional system,

SIBLING INTERACTIONS

Problems with siblings are a common concern of both children and their parents. Sixty-five percent of children report fights with their siblings that only decrease "some" after third grade and reduce "more significantly" after one of the children passes 15 years of age. Many factors are associated with greater sibling rivalry, including opposite gender,

Peer Relationships

PLAY

One of the most obvious tasks of developmental progress for the preschool child is learning to interact happily with peers. At the age of 2 years, most play still is parallel, although children frequently look at peers and copy some of their actions. By the age of 3, children should have mastered aggression and should be able to initiate associative play with a

TABLE 1. Peer Relationships

2-YEAR VISIT 3-YEAR VISIT 4-YEAR VISIT 5-YEAR VISIT

Amount of Parallel play with Takes on a role, Interactive games, Group of

interaction peers, copies others, prefers some friends best friend <2 y friends

self-talk, solitary over others, plays difference, may

play, offers toy, associatively with visit neighbor

plays games others by self, plays

cooperatively

with others

Duration of Briefly alone from 20 min with peers Prefers peer play

interaction adult, sudden to solitary

shifts in intensity

of activity

Level of Symbolic doll, action Simple fantasy play; Elaborate fantasy

TOILETING

To be independent in toileting, children must be able to signal the need before voiding, walk, climb, pull their clothes up and down, be dry for several hours during the day, understand what the toilet is for, and be motivated to model after adults and please them. On average, these skills come together around age 2 1/2, although 61% of cultures train at the age of walking or even during early infancy. However, such training generally requires much effort on the part of the parents, followed by close attention to infants' signaling to help them get to an appropriate place to eliminate. It is also important that parents who attempt early toileting not misinterpret the likely episodes of potty training, poty training, toilet training