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Family Relationships
"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, should be mastered during the preschool period. Displays of uninhibited anger and frustration increase during the second year and then decrease in
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
The average 3-year-old child can separate easily from parents and go to known adults. However, there is great variability before this age, related primarily to individual temperament. Some children cope by adopting a transitional object, usually a soft, malleable object that can acquire the odor of the mother, to carry in times of stress or separation, which serves as a symbolic reminder of the parent. The use of such an object is associated with greater, not lesser independent activity preschool, psychosocial, behavioral development, discipline, behavior, preschol, temper tantrums, tantum, sibling rivalry, potty training, toilet.
EMOTIONAL TONE
Beyond the most common factor of temperament, children develop their emotional tone in several ways. The pattern of
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,"
TANTRUMS
Temper tantrums 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 8 years of age, are associated with a family
OPPOSITIONALITY
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 authoritative and firm but also warm, encouraging, and rational are more likely to have children who are self-reliant and
One major concern of parents of preschoolers that affects both the relationship and the child's compliance is his 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, including health (eg, lead levels, anemia, past neurologic insult), current presence of medications, emotional problems such as anxiety or depression, environmental stresses, ability to see and hear adequately, hunger and fatigue, and temperament. Attention deficit disorder with (DSM 314.01) or without hyperactivity (DSM 314.00) is one of the most common mental health diagnoses of preschool children. Two to seven percent of preschoolers are affected, and it may coexist with oppositional defiant disorder (DSM 313.81 ).
A preschooler's aggression is said to reach the "problem" level when the negative impact of the behaviors causes people to change their routines, property begins to be damaged seriously, and the aggression is frequent. Symptoms rarely reach the level of a conduct disorder (DSM-PC 312.81) before 5 or 6 years of age, but the launching of such a trajectory can be seen.
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, difficult temperament, insecure pattern of attachment, family discord, corporal punishment, and, most importantly, perception of
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 peer, have
Pretend friends are very common in children up to the age of 4. These fantasy figures often fill the role of scapegoat for misbehavior, demonstrating that the child recognizes correct behavior but cannot always do the right thing. Alternatively,
Fathers play an important role in teaching young children to modulate their aggression, partly through horseplay on which the father sets limits. Boys raised without a father figure tend to have more difficulty mastering their aggression. Thwarting of any major developmental need can result in hyperaggressivity. Lack of adequate expressive language or fine
EMPATHY
Social development during the preschool years should include acquisition of the human characteristics of shame, guilt, empathy, self-awareness, and classification of events and preferences among peers. Although prosocial behaviors such as concern over the distress of others is present during infancy, children initially can take another's point of view with true
SEXUALITY
Sexual feelings are clearly present before the preschool years, but become more obvious now. Handling the genitals for pleasure (masturbation) peaks at 2 1/2 years of age before becoming more private, and exploring the genitals of others also is common. Compulsive masturbation or that which interferes with other activities or infringes on the rights of others is a problem that suggests sexual abuse. The solidification of gender identity and gender role identity occurs during the preschool period. Freud entitled this the Oedipal period in recognition of the working through of identification with the same-sex parent and letting go of sexual desires and possessiveness toward the opposite-sex parent in the face of competition with the spouse. Parents often are dismayed by their child's gender-stereotyped play, even when the family has espoused less traditional roles. Occasional cross-gender role playing and dressing is common, especially in girls, but it is of concern only if it persists for 6 months or includes statements that the child would prefer to be of the opposite sex and total rejection of attributes of his own sex (DSM-PC Cross-Gender Behavior Problem V40.3 or Childhood Gender Identity Disorder 302.6).
Independence
Throughout the preschool period, any child from age 2 to 5 years could regress momentarily to total infantile dependence, such as going limp and saying "I'm a baby," then quickly show absolute independence, declaring "I can do it myself," even when the task is something he or she has never done before.
EATING
Appropriate eating behaviors for a 2-year-old child include being able to use utensils well but with continued messiness and insistence on rituals. Attempts by a parent to intervene in preventing the mess should be avoided, and their reasons for such interventions should be elicited. Such reasons may include impatience with "babyishness" that the mess represents or a need to continue spoon-feeding their "baby" instead of allowing the autonomy that self-feeding represents. By age 3, children can be expected to feed themselves without spilling much and, if given the opportunity to pour from small
DRESSING
Parental report of independence in dressing should reveal the 2-year-old's ability to and penchant for taking off clothing, including shoes, socks, and pants, but a lack of success in dressing beyond cooperation by thrusting arms through sleeves. Although the 2 1/2-year-old can undress completely, there may be typical resistance to dressing and attempts to run and
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
Motor and Cognitive Aspects of Play
The type of play a child prefers reflects cognitive, fine and gross motor, and visual perceptual motor skills. Children will not play for long at activities that frustrate them because of a lack of ability. Fine motor and visual perceptual motor
Fine motor skills. Parents generally describe only extreme problems with fine motor skills. They may notice a need for help with utensils, continued finger feeding, or difficulty in dressing oneself after the usual ages of attainment. Delays in