01.06 Growth & Development – Preschoolers

Hey guys! We are moving on to Preschoolers and I have to say I love this age group. Just like lessons on toddlers and infants, we are going to cover what milestones to be looking for, how this affects your interactions with them and then look at common problems and patient education topics.

Preschoolers are 3-5 years old. In these 3 years they really transition from chubby, baby-like kids who still need a lot of help to more slim, very agile kids who can very nearly get themselves ready in the morning. At the same time they are becoming a lot more social, still a little egocentric, but starting to be able to look outside of themselves a bit.


Growth is pretty consistent and stable for preschoolers. They gain about 5 lbs per year and grow 2-3 inches per year. Rather than seeing trunk get longer, the growth will probably come from the legs.

So we said toddlers were still pretty clumsy, well preschoolers become much more graceful- with fewer falls and episodes of toppling over. Coordination and eye hand coordination improve by leaps and bounds.

Just a reminder that by this point you aren’t likely to pick up on motor delays. What you need to be on the lookout for are regressions. We talked about these some in the growth and development overview lesson.

Language for a preschooler is pretty comprehensive. They are pretty hilarious and can spin a story out of nothing and come up with the craziest ideas. Sometimes this can make getting a good understanding of what happened or what hurts a little difficult, but if you ask them really direct questions they can usually give you helpful information about how they are feeling.

A red flag to note here - by age 3 their speech should be clear. It’s pretty normal for toddlers to have their own cute little baby talk that only their parents understand, but by preschool years this should change and people who don’t already know the child should be able to understand them.

Preschoolers are in the initiative vs guilt phase. They are so eager to try new things and are so proud of themselves when they accomplish them. Equally they can get very upset and feel guilty when they don’t.

So much of what is happening during these years prepares kids to attend school- one of the shifts that happens around 3 years is a change in their play. All of the sudden play becomes very involved with a lot of coordinating and cooperating. Where before this everything was all about the family, preschoolers start to really enjoy playing with other people their own age. We call this cooperative play. If a child displays no interest in cooperative play and seems to always prefer being alone, this can be considered a red flag for social development.

Three things that can make caring for preschoolers a little difficult are their magical thinking, their poor concept of time and having an extreme fear of injury. With magical thinking the preschooler may think that their illness is a punishment for something they thought or did, so it’s important to reassure them it’s not a punishment! With a poor concept of time you have to be careful of causing anxiety in the hospital by preparing them for a procedure too far in advance. Ideally, you just tell them shortly or immediately before the procedure. This is true for toddlers as well. They are extremely worried about things like having holes in their body so always come prepared with a bandage to help them feel secure.

So- you can tell the preschool years are kind of a more stable time developmentally- the same is true for school-age. While there are still a lot of important things happening developmentally, the risks are decreasing so there isn’t as much going on in terms prevention and education. Most problems for preschoolers are either just common illnesses or injury related. So for this age group most of education is still around that common theme of safety and prevention.

One thing we do add to the picture now though is the kid having a slightly wider social experience. So we are now educating the kid and parents on topics like traffic safety, sexual abuse prevention, dental health and other important self-care topics. Take a look at the outline for more details on these topics.

Your priority nursing concepts for this content are human development, patient centered care and health promotion
Okay guys, that wraps up our chat about kids ages 3-5. Your key learning points for this age group are 1) To remember that the driving force is their energy and enthusiasm for trying new things, so they are constantly taking the initiative to master new skills. Number 2) their social experiences are really expanding. So we want to see a transition from a preference for playing solo to a preference for playing with other kids. Number 3) their unique way of thinking means we have to be extra careful about what we say, how we say it and when we say it. And lastly, number 4) Their development at this age has the end goal of being ready to go to school. Parents may be worried about this so education topics will tend to be aimed at supporting this transition.

That’s it for our lesson on growth and development during preschool years. Make sure you checkout all the resources attached to this lesson. Now, go out and be your best self today. Happy Nursing