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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.

"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.


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.


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.


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.


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.


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.

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.

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.


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.