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The Merck Manual--Second Home Edition logo
 
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Chapter 268. Normal Preschool and School-Aged Children
Topics: Introduction | Physical Development | Intellectual Development | Social and Emotional Development | Promoting Optimal Health and Development | Preventive Health Care Visits
 
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Promoting Optimal Health and Development

There are a number of ways parents can help their children achieve the best possible health. For example, obesity can be prevented with healthy eating patterns and regular exercise. The child should consume a variety of healthy foods, including fruits and vegetables along with protein. Regular meals and small nutritious snacks encourage healthy eating in even a picky preschooler. Although the child may avoid some healthy foods, such as broccoli or beans, for a period of time, it is important to continue to offer healthy foods. In addition, parents should limit intake of fruit juices. Some children lose their appetite for food at mealtime if they drink too much fruit juice. A child who drinks from a bottle should be weaned by about 1 year of age to prevent excess juice and milk intake and to avoid tooth decay.

Promoting optimal development in a child works best if approached with flexibility, keeping the individual child's age, temperament, developmental stage, and learning style in mind. A coordinated approach involving parents, teachers, and the child usually works best. Throughout these years, children need an environment that promotes lifelong curiosity and learning. The child should be provided with books and music. A routine of daily interactive reading, with parents asking as well as answering questions, helps children pay attention, read with comprehension, and encourages their interest in learning activities. Limiting television and electronic games encourages more interactive play.

Playgroups and preschool have benefits for many young children. Children can learn important social skills, such as sharing. In addition, they may begin to recognize letters, numbers, and colors; learning these skills makes the transition to school smoother. Importantly, in a structured preschool setting, potential developmental problems can be identified and addressed early.

Parents who are in need of childcare may wonder what the best environment is and whether care by others may actually harm their child. Available information suggests that young children can do well both in their own home and in care out of the home, as long as the environment is loving and nurturing. By closely watching the child's response to a given childcare setting, parents are better able to choose the best environment. Some children thrive in a childcare environment where there are many children; others may fare better in their own home or in a smaller group.

When the child begins to receive homework assignments, parents can help by showing interest in the child's work, by being available to sort through questions but not finishing the work themselves, by providing a quiet work environment at home for the child, and by communicating with the teacher about any concerns. As the school years progress, parents need to consider their child's needs when selecting extracurricular activities. Many children thrive when offered the opportunity to participate in team sports or learn a musical instrument. These activities may also provide a venue for improving social skills. On the other hand, some children become stressed if they are "over-scheduled" and expected to participate in too many activities. Children need to be encouraged and supported in their extracurricular activities without having unrealistic expectations placed on them.

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