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Early Childhood (3-5 Years of Age) Preschool

Children in the preschool years continue with development skills learned in the
earlier years of growth. Their sense of identity becomes clearer, and their world expands to
encompass involvement with others external to the family unit. Children in this
developmental category acquire new behaviors that give them more independence from
their parents and allow them to care for themselves more autonomously. Learning during
this time period occurs through interactions with other and through mimicking or modeling
the behaviors of playmates and adults (Richmond & Kotelchuck, 1984; Whitener et al., 1998).
Teaching Strategies
The nurses interactions with preschool children and their parents are often sporadic,
usually occurring during occasional well-child visits to the pediatricians office or when
minor medical problems arise. During these interactions, the nurse should take every
opportunity to teach parents about health promotion and disease prevention measures, to
provide guidance regarding normal growth and development, and to offer instruction about
medical recommendations when illness do arise. Parents can be a great asset to the nurse
in working with children in this developmental phase, and they should be included in all
aspects of the educational plan and the actual teaching experience. Parents can serve as
the primary source to answer questions about childrens disabilities, their idiosyncrasies,
and their favorite toys- all of which may affect their ability to learn (Hussey & Hirsh, 1983;
Ryberg & Merrifield, 1984; Woodring, 2000).
Childrens fear of pain and bodily harm is uppermost in their minds, whether they
are well of ill. Because young children have fantasies and active imaginations, it is most
important for the nurse to reassure them and allow them to express themselves openly
about their fears (Heiney, 1991). Choose your words carefully when describing procedures.
Preschool children are familiar with many words, but using terms like cut or knife is
frightening to them. Instead, use less threatening words like fix, sew, or cover up the
hole. Band-Aids rather than dressings is a much more understandable term, and
bandages are often thought by children to have magical healing powers (Babcock & Miller,
Although still dependent on the family, the young child has begun to have
increasing contact with the outside world and is usually able to interact more comfortably
with others. Nevertheless, significant adults in childs life should be included as
participants during teaching sessions. They can provide support to the child, substitute as
the teacher if their child is reluctant to interact with the nurse, and reinforce teaching at a
later point in time. The primary caretakers, usually the mother and father, are the recipients
of the majority of the nurses teaching efforts. They will be the learners to assist the child in
achieving desired health outcomes (Hussey & Hirsh, 1983; Kennedy & Riddle, 1989;
Whitener et al., 1998).
The following specific teaching strategies are recommended:
Short-Term Learning
Provide physical and visual stimuli because language ability is still limited, both
for expressing ideas and for comprehending verbal instructions.
Keep teaching sessions short (no more than 15 minutes) and scheduled
sequentially at close intervals so that information is not forgotten.
Relate information needs to activities and experiences familiar to the child. For
example, ask the child to pretend to blow out candles on a birthday cake to
practice deep breathing.
Encourage the child to participate in selecting between a limited number of
teaching-learning options, such as playing with dolls or reading a story, which
promotes active involvement and helps to establish nurse-client rapport.
Arrange small group session with peers as a way to make teaching less
threatening and more fun.
Give praise and approval, through both verbal expressions and nonverbal
gestures, which are real motivators for learning.
Give tangible rewards, such as badges or small toys, immediately following a
successful learning experience as reinforcers in the mastery of cognitive and
psychomotor skills.
Allow the child to manipulate equipment and play with replicas or dolls to learn
about body parts. Special kidney dolls, ostomy dolls with stomas, or orthopedic
dolls with splints and tractions provide opportunity for hands-on experience.
Use storybooks to emphasize the humanity of healthcare personnel; to depict
relationships between the child, parents and others; and to assist with helping the
child identify with particular situations.
Long-Term Learning
Enlist the help of parents, who can play a vital role in modeling a variety of
healthy habits, such as practicing safety measures and eating a balanced diet.
Reinforce positive health behaviors and the acquisition of specific skills.
Source: Nurse as Educator: Principles of Teaching and Learning for Nursing Practice, Susan B. Bastable