INTRODUCTION

The preschool years are a time of what seems like constant movement. A

preschool child is between the age of three and six years old. According to Virtual

Lab School (2016), preschoolers are busy moving in their environments, both

indoors and outdoors. Their motor skills are significantly refined from the time they

were toddlers. They are more coordinated than toddlers and more purposeful in

their actions. They demonstrate speed and strength, and they become

increasingly more independent. Oguejiofu, (2019) also added that during the

preschool years, there is a steady increase in children’s height, weight, and muscle

tone. Compared with toddlers, preschoolers are longer and leaner. Their legs and

trunks continue to grow, and their heads are not so large in proportion to their

bodies. As preschoolers’ bodies develop over time, the areas in their brains that

control movement continue to mature, thus enabling them to perform gross-motor

skills such as running, jumping, throwing, climbing, kicking, skipping, and

fine-motor skills such as stringing beads, drawing, and cutting with scissors.

In the psychosocial theory of Erik Erikson, he states that, preschooler children

takes place in the third stage of psychosocial theory which is initiative vs. guilt. In

this stage, they begin to assert their power and control over the world through

directing play and other social interactions. Moreover, Sigmund Freud’s Theory of

Psychosexual describes preschool children as phallic. Freud believed that

children’s pleasure centres focused on their genitals. It focuses on

self-manipulation of the genitals as providing the major source of pleasurable

stimulation. On the other hand, James Fowler on his theory of Spiritual

Development, he classifies the preschoolers in Intuitive–Projective stage in which

children are beginning to be able to use symbols and their imaginations. However,

children in this stage are very self-focused and inclined to take very literally ideas

about evil, the devil or other negative aspects of religion. The ability to sort out

reality from fantasy is not well developed.

Furthermore, Metro Manila Developmental Screening Test (MMDST) is a

simple, clinically useful tool used in the early detection of children with serious

developmental delays developed by Dr. Phoebe D. Williams. It is designed to

detect delays from children aging two weeks to six and a half years of age.
MMDST evaluates 4 sectors of development: Personal-Social, Fine Motor

Adaptive, Language and Gross Motor Behavior.

We, the Group 2, Subgroup 2 of BSN 2J chose the case of a 4 years, 7 months

and 7 days old child. She is Client PRC who currently lives in Cory Village,

Dacudao, Davao City. A student of San Roque Elementary School, Lacson Street,

Bo. Obrero, Davao City as a preschooler student. She is a first born and an only

child of the family. A Filipino citizen and a Roman Catholic by religion. Client PRC

is a responsible student who copes well in the lessons and manifest a worthy

character to her fellow classmates. She is participative in every activities of her

teacher and is able to interact well with others. During the interview, she was able

to properly demonstrate and performed the test given to her which made her as a

perfect subject of our care.

This study was shouldered to examine the health status and condition of a

preschooler student through assessment, observation and evaluation. It also aims

to help the student attain optimal health during the course of education.

OBJECTIVES

GENERAL OBJECTIVES

At the end of two weeks School Nursing Rotation at San Roque

Elementary School, Lacson Street, Bo. Obrero, Davao City, the student nurses

of Group 2-Subgroup 2 will be able to acquire important knowledge and apply

the skills to assess the growth and development of the pre-schoolers in order

to help them attain and maintain an optimum health status so that they will

receive maximum benefit from their educational experiences.

SPECIFIC OBJECTIVES

Specifically, we will be able to:

1. Identify suitable client to be the subject of our care.

2. Build and maintain good rapport with the client.

3. Gather essential biographical data of the client such as name, age,

address, etc.

4. Compute the age of the client.

 5. Assess client’s abilities to perform by applying the four areas of MMDST

(Metro Manila Developmental Screening Test).

6. Interpret the MMDST test result by using the criteria (normal, abnormal,

questionable and untestable) in order to determine the status and

condition of the client.

7. Assess the client cephalocaudal (head to toe) to determine body build,

dentition, etc.

8. Observe client’s growth and development by letting the client perform

some activities such as jumping, skipping, running, etc.

9. Assess client’s nutrition through an in depth interview about dietary

intake, eating habits and BMI (Body Mass Index).

10. Describe the client’s toilet training, activities and sleeping pattern.

11. Conduct an in depth interview with the client to determine its cognitive,

spiritual and moral development.

12. Provide a conclusion based on the findings and observations presented.

PERSONAL DATA

Name of Patient: P.R.R.C

Birthdate: June 08, 2014

Age: 4 Years, 7 Months and 7 Days

Ordinal Rank: Second Born Child

Address: Cory Village, Dacudao, Davao City

Nationality: Filipino

Religion: Roman Catholic

Name of Father: Carlito

 Age: 27 years old

 Occupation: Backhoe Operator

 Educational Attainment: High-School Graduate

Name of Mother: Dianne

 Age: 32 years old

 Occupation: Housewife
  Educational Attainment: High-School Graduate

COMPUTATION OF AGE

Y M D

Date of Test 2019 06 15

Birthdate 2014 11 08

Total: 4 Years 7 Months 7 Days

DESCRIPTION OF TEST ITEMS

The Metro Manila Developmental Screening Test (MMDST) was administered

and used to assess the client’s abilities. A series of test which comprises four
sectors of development was used namely: personal-social, fine motor adaptive,
language and gross motor behavior. These series of tests were done in order to
assess the development of the preschooler along with a few trials and set of test
items.

Actual Actual Rationale

Administration Observation and
Score

Personal Social

1. Buttons Up Ask the parent if Client PRC passed During the early
(75%) the child can button the test because childhood years,
any piece of when she was told children learn to
clothing. to unbutton and manage and take
button her school control of their
uniform. She gladly bodies. They
obliged to do so become more
and was able to aware of what their
correctly perform bodies can and
the said task. She can’t do. In the
buttoned her preschool stage,
clothes and places children are
it on the correct learning life skills
holes. such as buttoning
or using silverware.
(Carrero, 2018)
2. Dresses with Ask the parent if When Client PRC According to
Supervision the child can dress was asked as to Shepherd, J.
(80%) himself. If so, how whether she was (2014), children
much help is able to dress on her tend to dress
needed? own. She independently
responded that she when asked and
is able to identify want to have the
front from the back self-assurance that
of her dress. She he or she can do
also added that she these small simple
can put on and take things.
off her clothes
without the help of
her parents except
for tying her shoe
laces. By this,
Client PRC passed
the test.

3. Separates from At the end of the Client PRC passed According to

mother easily test, see how the the test because McKinney &
(70%) child acts when he from our interview, Murray (2018),
is asked to stay Client PRC stated preschoolers can
with the tester that her mother now be left
while the parent was at home. She independently to
leaves the room, or was fetched by her other people
see if the child will grandfather every because
leave the room with after class. Thus, separation anxiety
the tester without Client PRC is able is now lessened at
the parent. This to tolerate without this stage. Also,
should not be done getting upset if her Rushton,
before the end of mother will leave Eitelgeorge, and
the test in case the her at school. Zickafoose (2003)
child gets upset. However, the child states that, it is only
can somewhat feel natural for kids to
a little bit of anxiety feel anxious when
when saying saying goodbye to
goodbye to her their parents. In
mother. fact, separation
anxiety is a normal
part of child
development.
4. Dress without Ask the parent if Client PRC states According to
Supervision the child can dress that she can Shepherd, J.
(25%) himself without any already dress on (2015), children
help. her own. tend to dress
Sometimes, she independently
just need when asked and
assistance from her want to have the
father in tying her self-assurance that
shoe laces. Thus, he or she can do
base from the these small simple
guidelines, Client things.
PRC passed the
test.

Fine Motor Adaptive

1. Copies (+) Show the cross on Client PRC was Based on

(90%) the back of the test able to draw two Anderson (2016),
form to the child. intersecting lines during preschool,
Do not name it or representing a amazing changes
move your finger or cross figure. She happen in
pencil to show how did it by drawing children's "thinking
to draw it. Tell the two lines skills.” They can
child to draw one intersecting each share their ideas in
like the picture. other. The cross is new and interesting
correctly and ways. Their
straightly done. imaginations are
Thus, she passed becoming a
the test. primary vehicle for
play and learning.
Children at this age
are becoming
complex and they
develop more their
fine motor and start
to imitate and copy
what they are being
told to.

2. Copies (O) Show the circle on In administering the Based on

(85%) the back of the test test, the client was Anderson (2016),
form to the child. shown a circle during preschool,
Do not name it or figure and amazing changes
move your finger or instructed to draw happen in
pencil to show how one like the picture. children's "thinking
 to draw it. Tell the She was able to skills.” They can
child to draw one draw a circle figure share their ideas in
like the picture. even though not a new and interesting
perfect circle but ways. Their
still, she was able imaginations are
to passed the test becoming a
basing on the primary vehicle for
guidelines play and learning.
presented. Children at this age
are becoming
complex and they
develop more their
fine motor and start
to imitate and copy
what they are being
told to.

3. Imitates First, see if the At the first attempt, It is well

Demonstration child can copy from even without established that
(20%) the picture without demonstrating how preschool children
being shown how to draw a square imitate the actions
to draw the figure. figure, still, the of others. Children
If he cannot, show client was able to as young as 2 to 8
the square on the follow just based on years old are often
back of the test our instructions. imitating not the
form to the child. However, we still literal observed
Do not name it or continued doing action but the
move your finger or the procedure by action they thought
pencil to show how demonstrating it to the actor
to draw it. Tell the her how to draw a intended—the goal
child to draw one square figure and or the rationale
like the picture, the she was still able to behind the action.
tester should show follow it correctly. (The National
him how by Hence, the client Academies of
drawing two successfully Sciences,
opposite sides passed the test. Engineering and
rather than drawing Medicine, 2019)
the square with a
continuous motion.
When the square is
drawn with a
continuous motion
it may appear
round to the child.
 Demonstrate.

4. Draws Man in 3 Give the child In administering the Preschoolers tend

Parts (25%) pencil and paper test, a pencil and to have such active
snd tell him how to paper was given to imaginations that
draw a picture of a the child. After that, they need little
boy and girl. Do not we instruct him to guidance in this
tell him to add other draw a girl and a type of play. They
parts to his boy. Then, Client smear both hands
drawing. When he PRC was able to into clay or finger
seems to have draw a boy and a paint and create
finished his girl with more than instinctively.
drawing, ask, “are 3 parts. Hence, he Pillitteri, A. (2018).
you finished?” If the passed the test.
child answers,
“yes”, score the
drawing.

5. Draws Man in 6 Give the child A pencil and paper Preschoolers tend
Parts (10%) pencil and paper were given to the to have such active
snd tell him how to child and we had imaginations that
draw a picture of a him draw a girl or a they need little
boy and girl. Do not boy. Then the child guidance in this
tell him to add other was able to make a type of play. They
parts to his man with 6 parts. smear both hands
drawing. When he He was able to into clay or finger
seems to have draw the eyes, paint and create
finished his nose, mouth, neck, instinctively.
drawing, ask, “are arms and legs of a Pillitteri, A. (2018).
you finished?” If the person.
child answers,
“yes”, score the
drawing.

6. Picks Longer Show the parallel When Client PRC

Lines (75%) lines on the back of was asked as to
the test form to the whether which line
child and ask him, is bigger basing on
“which line is the picture
bigger?”. After the provided, she
child has pointed to responded and
the line he thinks is chose the line
longer, turn the bigger than the
 sheet upside down other. When the
and ask the paper is put upside
question again. down, still, the
This must be done client was able to
at least three times. identify which line
is more bigger.
Thus, Client PRC
passed the test.

Language

1. Comprehends Ask the child the When asked about

Cold, Tired and following the first statement,
Hungry (70%) questions, one at a she correctly
time: “What do you responded and
do when you are answered
tired?”, “What do “matulog”.
you do when you Moreover, when
are cold?”, and questioned about
“What do you do the “cold”, she
when you are responded that she
hungry?” will use a jacket to
cover the coldness.
Lastly, when asked
about being
hungry, she
answered foods.
Hence, basing on
the guidelines the
client passed the
test.
2. Comprehends 3 The tester should When the client
Prepositions tell the parent not was instructed to
(75%) to move and then put the block on the
give the child a following places
block. Tell him to do basing on the
the following, one guidelines, she was
at a time: “Put the able to correctly
block on the table.”, follow and place
“Put the block the blocks on and
under the table.”, under the table, in
“Put the block in front of her mother
front of mommy’s and behind her
chair.”, “Put the chair. Even though
block behind her client was a bit
chair.”. A wrong hesitant, she was
answer should not able to passed the
be corrected. test.

3. Recognizes 3 Place a red, blue, We placed four Preschoolers have

Colors (10%) green and yellow blocks in front of dramatic increase
block together on the preschooler over their language
the table in front of and asked him to skills, especially
the child. Tell the give us the block their vocabulary
child to point to or which and understanding
 give to you the red corresponded to on simple things.
block, the blue the colors. He was According to
block, etc. If the able to recognize Munsell (2016), the
child hands the 4/4 colors and give ability to identify
black to the tester, all the colors colors is
the block should be instructed to the considered a
replaced on the tester. Therefore, marker and
table before the Client PRC passed milestone in a
next color is asked the test. child's cognitive
for. Do not let the process and is
child know if is often part of early
responses are right screening for
or wrong. Do not development and
ask the child to educational
name the colors. admittance.

4. Opposite Make sure the child During the Preschool children

Analogies (60%) is listening to the assessment, the can both
tester and then child answered: understand and
say: “Fire is hot, ice spontaneously
1.) “Fire is hot, ice
is ____?” so on and produce a variety
is cold.”
so forth. of expressions
2.) “Mother is a based on similarity,
woman, dad is a an achievement
man.” that is considered
to be the earliest
3.) “A horse is big, a
form of
mouse is small.”
metaphorical ability
Thus, he passed
in young children
the test which
(Pérez-Hernández,
scored 3/3. The
Duvignau, 2016).
questions provided
were translated into
vernacular.

5. Give First and Ask the child, Client PRC was A preschooler child
Last Name (80%) “What is your able to recite her slows down his
name?” If he gives first and last name physical and motor
his last name or easily. She did not development.
both names. stutter and even However, their
Probe. included her middle intellectual, social,
name. Hence, she and emotional
passed the test. aspect begins to
 develop fast. At this
time, the child can
fully say his name,
recite some difficult
words, etc.
(American Academy
of Pediatrics, 2018)

Gross Motor Behavior

1. Balance on 1 Show the child how The assessment As preschoolers’

Foot for 10 to stand on 1 foot was successfully bodies develop
Seconds (50%) without holding on done by Client PRC over time, the
and tell him to do it. and thus, she areas in their
Time him with a passed the test. brains that control
watch, if possible. She was able to movement
Allows 3 trials if balance using her continue to mature,
needed. one foot only on a thus enabling them
first try. She was to perform
timed and able to gross-motor skills
passed 10 such as running,
seconds. jumping, throwing,
climbing, kicking
and skipping (Berk,
L. E., 2015)

2. Hops on 1 Foot Tell the child to hop Client PRC passed Developmental
(90%) on one foot. The the test because milestone are
tester may show she was able to things most
him how to do this. hop using her one children can do by
foot without holding a certain age.
unto anything. Some examples of
Even though she this are, naming
has difficulty colors, hopping on
balancing, still, she one foot and
was able to showing affection.
managed and (Centers for
successfully fulfill Disease Control
the given task. and Prevention,
2019)

3. Catches The tester stands Client PRC As preschoolers’

Bounced Ball about 3ft from the successfully bodies develop
(55%) child and bounces passed the test. over time, the
the ball to him, During the first try, areas in their
 taking care to have she failed to catch brains that control
the ball bounce the ball. However, movement
once halfway when she was continue to mature,
between the tester asked to catch the thus enabling them
and the child. The ball after bouncing to perform
ball should reach during her second gross-motor skills
the child between try, she hurriedly such as running,
his neck and waist. took the ball and jumping, throwing,
The child is told to was able to catch it. climbing, kicking
catch the ball. and skipping (Berk,
Allow five trials if L. E., 2015)
needed.

4. Heel to Toe Show the child how During the According to

Walk (50%) to walk placing the assessment, the Fischer (2017), toe
heel of one foot in test was first walking is a pattern
front of and demonstrated to of walking in which
touching the toe of the child. After that, a child walks on
the other. Walk Client PRC was balls of his or her
about 8 steps like allowed to perform feet with no contact
this and tell the the test and she between the heels
child to do it. If the have done it and ground. Toe
child does not successfully with walking is common
respond, show him ease. Therefore, in children who are
how to do it again. she passed the test learning to walk.
Allow three trials if basing on the After the age of 2,
needed. guidelines. however, most
children outgrow
toe walking and
begin to walk with a
normal heel-to-toe
pattern.

INTERPRETATION

In personal-social sector, Client PRC was able to passed the four tests

included: buttons up, dresses with and without supervision and separates from

mother easily. Based on the result, the child was interpreted to be normal in her

personal-social development. This indicates the child’s ability to get along with

people and taking care of himself.

In the fine motor adaptive sector, six test was administered namely: copies
( and 0), imitates demonstration, draws man in three and six parts and picks longer

lines. On the administration of test, the client passed the four test presented. Thus,

the client has a normal fine motor development and indicates the child’s ability to

see and use his hands to pick up objects and draw.

Moreover, there are five tests administered in the language development.

These are: comprehends cold, tired and hungry, comprehends three prepositions,

recognizes three colors, opposite analogies and give first and last name. Based on

the results, the client passed the five tests presented. Therefore, the language

development is normal and this indicates the child’s ability to hear, follow directions

and speak.

Lastly, for the gross-motor development, four tests were administered

accordingly: balance foot for ten seconds, hops on one foot, catches bounced ball

and heel to toe walk. The child was able to do this with ease and thus interpreted to

be normal. This indicates the child’s activities that require whole body movements

and which involve the large (core stabilising) muscles of the body to perform

everyday functions, such as standing, walking, running, and sitting upright.

Therefore, Client PRC was interpreted to be a normal preschool student. She

was able to completely pass the MMDST set of test items administered to her. This

shows that Client PRC do not manifest any developmental delays as a child. As

evidence, Client PRC performed well in the activities even better than expected.

Even the hatchmark shows a little number of percentage, still, the client was able

to passed the test higher than its expected percentage for a normal child.

GENERAL OBSERVATION

A. Physical Description

I. General Survey

Client PRC was observed to have an ectomorph body structure with a

height of 39 inches and a weight of 19 kgs. Her calculated BMI is 19 kgs/m2
which is perceived to be normal. Her body posture is normal. She is alert and
oriented. However, she has disheveled clothes due to her being active. Vital
signs results are as follows: HR: 86 bpm, RR: 20 cpm, BP: 100/80 mmhg, PR:
80 bpm and Temperature of 35.5 degrees celsius.

II. SKIN
 Her skin appeared to have a smooth texture and good turgor. Has a
uniform skin color with no skin lesions, edema and ulcerations noted. Nails is
not well-trimmed with accumulation of dirty black color due to playing.

III. HEAD

Head is found to be normocephalic. No lesions and any deformities noted.

Fontanelles are fully closed. Skull and face is symmetrical and hair is normally
distributed.

IV. EYES

Eyebrows are aligned and has symmetrical movement. Lacrimal ducts

are also noted to be normal. Lashes are curled inward with smooth cornea and
lens. Conjunctiva is pinkish with anicteric sclera. Pupil is isocoric.

V. EARS

Ears are normoset. There are no discharges and foul smell was not
observed. Hearing acuity is normal.

VI. NOSE

Nasolabial folds are symmetrical and septum at midline. Both nasal

passes is patent and free from lesions, discharges and swelled sinuses.

VII. MOUTH

Lips are pink, moist and symmetrical. Tongue is at the midline.

VIII. DENTITION AND GUMS

Teeth are complete but with presence of dental carries noted due to usual
intake of sweet foods such candies and bubble gums. Gums and mucosa is
observed to be pinkish.

IX. PHARYNX

Uvula at midline and mucosa is pinkish. Tonsils are not inflamed and has
(+) gag reflex.

X. NECK

Trachea at midline with non-palpable lymph nodes and thyroid. Range of

motion and muscle strength is normal. No jugular vein distention noted.

XI. THORAX

Shape is symmetrical with normal spinal alignment. There are no bulges,

tenderness and lesions. There is no difficulty in breathing has been observed.
Chest skin turgor is good and respiratory excursion is symmetrical. Tactile
fremitus is symmetrical. Resonant sound heard when percussed.
 Diaphragmatic excursion is 3cm. No adventitious breath sounds noted.

XII. HEART

Precordium is normodynamic. Heart sounds in aortic, pulmonic, tricuspid

and apical areas are distinct. Pulses in temporal, carotid, brachial, radial,
popliteal, dorsalis pedis, and posterior tibia are strong. Apical pulse is regular.
Calf tenderness is (-) both right and left.

XIII. BREAST

Breast was not assessed due to inavailability of consent from parents.

Thus, this part is not applicable.

XIV. ABDOMEN

Skin is intact and flat. Bowel sounds are normoactive and no

abnormalities noted.

XV. LOWER EXTREMETIES

Extremities are symmetrical in size and length. The muscles are equal in
size with the absence of tremors. They are smooth and coordinated in
movements.

XVI. GENITO-URINARY SYSTEM

Due to lack of resources and unavailabilty of consent from parents, the

genito-urinary system was not assessed. Thus, this part is not applicable.

B. Growth and Development

The growth and development of Client PRC.

C. Nutrition

During the assessment, we have noticed that the student consumed a

polvoron and calamansi juice for her snacks. Client PRC was asked to recall what
she ate for the last 24 hours. She enumerated rice and ham for breakfast, rice and
egg for lunch and soup and rice for dinner. Client PRC is able to eat three complete
meals a day and one snack during daytime. She likes to eat vegetables and
dislikes candies because according to her, it can destroy her teeth. She is also
restricted by her mother to eat unhealthy foods as this can cause illnesses. She
stands 39 inches tall and 19 kg in weight resulting to a body mass index of 19
kgs/m2 which is normal.

According to Flagg & Pilliteri (2018), as with all age groups, foods selected for
preschoolers should include variety because no single food can provide all the
necessary nutrients that the body needs.

D. Toilet Training
 During the assessment, the child did not void or defecate. During day time
when she needs to void, she goes to the restroom directly until she cannot hold it.
According to her grandmother, Client PRC still does not know how to defecate on
her own. However, she does not pee on her pajamas anymore during night time.
When she feels the need to void or defecate, she verbalizes it with “ma kalibangon
ko” or “kaihion ko ma.” There are no accidents recalled that happened. Also, there
are no signs of toilet regression present.

According to McKinne& Murray (2018), pre-schoolers are expected to have

control of their need to void and defecate because during toddlerhood the myelination
of the spinal cord is already complete which allows for the control of urinary and anal
sphincters.

E. Activities, Play and Sleep

Client PRC’s usual routine on weekdays is going to school. While during

weekends, she stays at home and helps her mother with the house chores by
sweeping the floor. We also asked her if what are her usual playing routines, and
we have learned that she plays gross motor activities such as appear-disappear,
hide and seek, patintero and tumba-lata. While her fine motor activities are doing
puzzles and coloring a drawing book. The toys of Client PRC include: barbie,
house and kitchen set. Her usual playmates are her younger siblings and her
friends from their community.

Moreover, she usually sleeps at 8:00 pm in the evening and wakes up at 6:00
am in the morning to prepare for school. According to Flagg & Pilliteri (2018), many
toddlers, who go through a typical negative phase, resist taking naps no matter how
tired they are. Many give up afternoon naps. If they nap at preschool, they may have
some difficulty going to sleep at the usual bedtime established at home.

F. Fears

Client PRC has fear in the dark, clowns, and being alone. She is also afraid
when she is being scolded by her parents. Also, she states that she will call her
parents or sometimes pray when she was asked about her reaction if ever she will
see a ghost. Flagg & Pilliteri (2018) explained, due to preschoolers’ vivid imaginations
they have a number of fears such as fear of the dark, mutilation, cessation and
separation or abandonment.

G. Cognitive Development

1. Assimilation

The client was asked why can he see himself when he look at the mirror,
and the he answered “It’s a thing that make you see yourself.”

According to Piaget, children are born with a very basic mental structure
(genetically inherited and evolved) on which all subsequent learning and
 knowledge are based. Piaget, J., & Cook, M. T. (1952).

We explained to the client that a mirror reflects that’s why he can see
himself. The clients nods in agreement and say “okay”.

According to Piaget (1966), when accommodation occurs, children modify

their schemes to fit new information or experiences in their environment.

Magical Thinking

He said he likes to transform to car and be like iron man who fights off monsters.

Wong, Hall, Justice, & Hernandez (2015) said that magical thinking and fantasies
are common during this age, which lead to an increase in dramatic play.

 Role-Fantasy thinking

When we ask what kind of other games does he and his brother play he said “I like
to play as Antman because he is my favorite hero.

Preschool thinking is also influenced by role fantasy, or how children would like
something to turn out. (Pillitteri,2018)

 Centering

On the administration of MMDST test, we asked the client about the fence which
he said “"It is like a wood so what we cannot go outside the house.” The client can
already describe something with more than just one characteristic.

According to Pilliteri (2018), during this time children tend to look at an object and
see only one of its characteristics.

 Reversibility

The client was asked if an ice left in a sunny place will turn water, he answered
“Yes because it will melt.” When asked again what if I put it inside the freezer? To
then he replied “It will turn to ice again.”

Centering contributes to the preschoolers’ lack of reversibility. However

Children in the intuitive substage may demonstrate many advances in cognitive
skills. (Pilliteri, 2018).

 Conservation

When the client was asked to choose between a P5 coin and a five P1 coins, he
chose the P5 coin and when asked why, the client answered “They are just the
same.”

 Pre-logical reasoning

When asked how can a water turns into ice he answered “Because it’s cold.”
According to Piaget, children are born with a very basic mental structure
(genetically inherited and evolved) on which all subsequent learning and
knowledge are based. Piaget, J., & Cook, M. T. (1952).

 Ego-centrism

When we asked the client about why do you think people cry? He said “because
they are sad. When asked again why are they said he said “because they didn’t get
what they want.”

In both children and adults, egocentrism arises when they fail to recognize the
idiosyncratic nature of our own knowledge or the subjective nature of our own
perceptions. (Epley, et al. 2004).

 Can state cause and effect relationship

When we asked the client about why he needs to sleep early, he said “because I
will not grow taller when I sleep late.

Superficially, causality resembles logical thought. Preschoolers explain a concept

as they have heard it described by others, but their understanding is limited.
(Hockenberry, 2017).

H. Spiritual Development

Client PRC stated that she was taught by her mother to sing song of praises.
She also added that there are statutes of Sto. Niños and Mama Mary inside their
house. Flagg and Pilliteri (2018) states that, preschoolers begin to have an
elemental concept of spirituality if they have been provided some form of religious
training. It is reasonable for a child to develop and imitates parental behaviors
about spirituality especially if they have witnessed such practices while they are
growing up.

Client PRC also added that every sunday, her family go to church to worship
and pray. Moreover, when asked about the concept of God and faith, she talk
about Jesus and the importance of having faith especially when in distress.

I. Moral Development

During the interview, we gave a situation regarding disrespecting parents like

talking back and not asking the hand for respect. She responded that such actions
are wrong and bad. When asked if she is doing it, she answered with a no and
shakes her head for disapproval. According to Flagg and Pilliteri (2018), children of
preschool age determine right from wrong based on their parents’ rules. However, they
have little understanding of the rationale for these rules or even whether the rules are
consistent.
 Furthermore, Client PRC shows signs of egocentricity because when her
classmate cried due to lack of glue, she tried to comfort her by offering glue which
could help her classmate to stop crying. Also, when we asked the child about her
reaction when someone will tell a lie, she said that she will be angry to that person.
Same with the case of stealing where we provided a situation assuming that her
classmate stole a pencil from her other classmate. She verbalized “isumbong nako kay
teacher”. Lastly, when asked about bullying, she said “bad man ang mangaway”.

CONCLUSION

Basing on the MMDST result, it has been concluded that our client is
physically well and normal. The client was able to passed the tests presented
above which indicates that the client has no any developmental delays. She was
able to perform all the sectors of MMDST such as personal-social, fine motor
adaptive, language and gross motor behavior. Thus, the client is a healthy child
with a developmental rate appropriate to her age.

According to Pilliterri, a preschooler is very creative and curious. Also, sibling

rivalry at this stage is common. In line with this, the characteristics are present in
our client because she likes to draw and color. She also love to fight with her older
brother.

And in comparison with the growth and development of a normal preschooler,

our client showed accurate results according to some of the theorists. For example,
Lawrence Kohlberg’s moral theory which states that a pre schooler is a level of
moral reasoning is as far as most people get. And that are capable of abstract
thinking necessary for stage 5 or 6 (post-conventional morality).

Further, we also have imparted important health teachings to our client

especially in her nutrition. We have emphasized the importance of nutrition to our
body. The client was advised to always choose the right food, right amount and to
eat at the right time. Children need proper nutrients to stay healthy and strong.
Good nutrition will also serve as foundation for a healthy eating habits and
nutritional knowledge that the child can apply throughout life.

At the end of the assessment, we were able to meet our objectives. We have
successfully fulfilled our tasks as student nurses as we were able to apply all the
necessary skills to assess the growth and development of our client. By this, we
have discovered what are the aspects of the child’s development that we need to
look into.

After all, as student nurses, the experiences have taught us many things
which are relevant for the better understanding of the student nurses about the
significance of the principles of growth and development of a preschooler which
states that different children pass through the predictable stages at different rates.
Therefore not all preschooler can achieve the tests given to them. There will be
many factors affecting it because children’s development during this stage are
strongly affected by their environment, and that effect continues to exert a strong
influence on the rest of their lives.

As you watch your child grow, remember that each child develops at his or her
own pace and the range of normal is quite wide. However, it is helpful to be aware
of red flags for potential developmental delays in children. These delays are
significant lags in one or more areas of emotional, mental, or physical growth. If
your child experiences a delay, early treatment is the best way to help him or her
make progress or even to catch up.

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APPENDICES