Health Promotion

1. Health Promotion Preschooler and School-Aged Child Part 1

2. Objectives • Identify changes in development in preschool and school-aged child from infant and toddler • Provide examples of development • Explain the need for parental education in caring for their pre-school and school-aged child • Describe some key activities of health promotion for the preschooler and school-aged child

3. Parenting Styles • Types • Authoritarian • Permissive • Neglectful • Intimidated • Secure • Must be adapted to child’s temperament

4. Preschooler and School-aged child • Preschooler ages 3-5 • Schooled-aged from 6 -12 years of age

5. Relationships • Parents • Step-parents • New Baby • Older Siblings • Grandparents • Other adults

6. Family Developmental Tasks • Increasing emphasis on accountability and measureable outcomes • Prepare the child for separation • Encourage and accept child’s skills • Maintain some personal privacy and outlet for tension • Share household and child-care responsibility

7. Family Developmental Tasks cont. • Strengthen partnership with mate • Learn to accept failures, mistakes, and blunders; rework codes and values • Nourish common interests and friendships • Create and maintain effective communication • Cultivate relationships with extended family • Tap resources and serve others

8. Assessment/Development

9. Assessment • Should consider more than chronological age • Whole and unique child must be considered • Many standardized tools that are focus on certain domains or cover each of the domains • Denver Developmental Screening Test (DDST) • Ages and Stages

10. Cognitive Development • Brain undergoes rapid spurts developmentally • Most rapid growth is in frontal lobe • Child learns by • Interacting with more knowledgeable people • Being confronted with others’ opinions • Being actively involved with objects and processes

11. Preoperational Stage • Literal thinking with absence of reference system • Intermingling of fantasy, intuition, and reality • Absolute thought and centering • Difficulty remembering conversation topic • Inability to state cause-effect relationships, categories, or abstraction

12. Preoperational Stage cont • Preoperational Stage is divided into 2 parts • Preconceptual Stage (2-4 years) • Intuitive Stage (4-7 years) • Another approach used is Vygotsky’s Sociocultural Theory • Cognitive growth occurs in sociocultural context and evolves out of child’s social interactions

13. Preschooler Communication • Use somatic or physical symptoms, action, and verbal expression • Learn new words quickly, flexibly, and efficiently • Connected to familiar words, experiences, or themselves • Participate in private speech, social speech, and later inner speech

14. Emotional Development • Child appears more self-confident and relaxed • Child ready for prosocial behavior • Encourage parents to be role models for standards of behavior • Encourage parents to choose stories, songs, games and videos that promote prosocial behavior

15. Initiative versus Guilt • Initiative is enjoyed energy displayed in action, assertiveness, learning, increasing dependability, and ability to plan • Guilt is sense of defeatism, anger, and feeling shameful or deserving of punishment • Guilt can come from excessive expectations, sibling rivalry, lack of opportunity, and lack of guidance

16. Adaptive Mechanisms • Fear is common • Frustration arises in response to self- and other’s expectations • Emotional regulation is a task • Mechanisms include introjection, secondary identification, fantasy, repression, and suppression

17. Self-Concept • Learning about the body is important at this stage • Child should learn some control over feelings and behavior • Child feels great self-esteem when a problem is faced and handled • Teach parents ways to increase the child’s self-esteem and self-concept and develop concept of body image

18. Sexuality • Preschooler • Identifies self as girl or boy • Adopts gender-appropriate behavior through identification • Interested in function and appearance of body • Teach parents that they foster gender roles • Encourage importance of variety of play activities and experiences

19. Moral and Spiritual Development • Child learns by example • Child needs simple explanation matched with daily practices to learn religion • Child develops superego at this stage • Child needs to learn about consequences of behavior on others • Teach parents importance of superego development and beginning moral development

20. Preschooler Play • Intrusive in play • Pregangstage-parallel play • Purposes include learning cooperation, expressing imagination, and building self-esteem • Play materials should be stimulating and encourage different types of play • Inform parents of their role in play

21. Areas for Health Promotion • Nutrition • Exercise • Sleep • Immunizations • Dental Care • Safety

22. Nutritional Needs • Review recommended daily nutritional intake • Guide for caloric intake is 1000 calorie baseline + 100 calories for each year of life • Protein, fat, and vitamins needed daily • Eating assumes social significance • Eating habits may include overeating or not wanting to eat

23. Exercise • Needs at least 60 minutes of active exercise daily • Needs time and space for physical exercise • Needs comfortable shoes and clothing • Needs adult-initiated rest periods

24. Sleep • Bedtime routines important • Sleep time decreases from 10-12 hours for younger preschooler to 9-11 hours for older preschooler • Dreams and nightmares occur • Emphasize that parents should teach sleep strategies and set limits • Help parents understand how to deal with night terrors and sleepwalking

25. Immunizations • Counsel about the benefit of state law • Ensure the following before giving immunization • Parent’s consent • Need for vaccination • Knowledge of contraindication or past history • Education to parents about administration, benefits, and risks • Proper storage and date of expiration

26. Dental Care • Dental carries begin at this age • Deciduous teeth guide in the permanent ones • Fluoride is important to dental health • Teeth should be brushed after eating • Refined sugar intake should be limited • Child required to have physical and dental examination before school

27. Safety • Teach parents • Developmental characteristics that may cause hazardous risk • Measures for teaching safety to the child • Measures parents can institute for child’s safety • Measures to avoid falls and related injury • Measures for parents to teach child related to abduction, running away, or getting lost • Why child may continually fail to listen or obey

28. Common Health Risks • Respiratory asthma • Inform about dangers of smoking • Bites from animals or children • Ensure dog does not have rabies • Lead • Watch for signs of lead poisoning

29. Child Maltreatment • Abuse can be physical, psychological, or sexual • Abuse can be intrafamilial or extrafamilial • Sexual abuse can be contact or noncontact • Abuse can be ritualistic • Abuse can be neglect • Abuse can cause autonomic or hyperarousal response

30. Developing Initiative in Preschooler • Encourage use of child’s imagination, planning, and creativity • Limit punishment to acts that are truly dangerous or wrong • Reinforce appropriate behavior • Affirm emotional experiences and set aside time each day to review them • Help preschooler learn about different feelings and how to express and cope

31. Development Tasks • Settle into healthy daily routine of eating, exercising, resting, and following health promotion • Master large- and small-muscle coordination and movement • Participate in life and activities of family • Identify with parents of the same gender • Conform somewhat to other’s expectations • Express emotions healthfully

32. Teaching a Child • Most critical factor is loving caretaker • Learning occurs from • Motor activity, play, and language games • Talking with adults and peers • Paying attention to both trivial and important aspects of environment • Avoid too much television or aggressive, fast-paced shows, videotapes, and videogames

33. Guidance and Discipline • Teach parents • Set consistent, fair, and kind limits that preserve parent’s and child’s respect • Stop immediately behavior that hurts others • Explain reasons for limits • Avoid spanking • Use time-out and reward to help guide behavior • Encourage parents to use age and developmentally appropriate discipline