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The following essay addresses various aspects of early childhood of 3-6 years age group and assesses the role nursing plays throughout the development process. Although development is a subjective process, certain criteria must be fulfilled at a given age. Children of this age group achieve a number of milestones like learning to sit up and walk and language development and so on. The primary interest of this essay is to assess the influence of physical and cognitive aspects of children of the concerned group, on his/her self-development. Review of the normative and the non-normative transition common to this age group and their relative impact are being discussed thoroughly. Finally, the effect of the discussed aspects on the nursing practice is worth consideration as early childhood parenting, and nursing proves to be the deciding factor in shaping an individual's overall character and personality.
3-6 years is described as the preschool development phase of a child. The child starts to gain control over his/her body. They start to engage themselves in different activities like grabbing stuff they can get a hand to and random movements of the various body parts. Studies show that a physically active lifestyle starts with an early childhood (Tammelin, Viikari & Raitakari, 2014). Certain interventions have been adopted to improve physical fitness in early childhood in order to fight the epidemic of childhood obesity (Zhou et al., 2014). The motor skills undergo significant development during this period. During this age, the child undergoes vast changes in cognitive behaviors and brain development. The plays and activities they engage themselves into become more imaginary creative. Piaget concludes that play is not just for fun, it plays a pivotal role in the development of the brain.
Piaget identified several levels of cognitive development in an individual’s whole life span. The pre-operational stage or the second stage is of relevance to our discussion. During preschool age, a child demonstrates signs of intelligence through symbols and language. Memory and imagination develop significantly. Intuitive thinking develops but in an illogical and irreversible manner. Often thinking patterns are egocentric (Mischel, 2013). Psychoanalyst Erik Erikson postulated the eight stage theory of psychological development considering the impact of parental and societal factors. Between an age of 2-5 years, a child undergoes a psychological crisis of initiative vs. guilt, the primary virtue of which is ‘purpose'. The child starts making decisions and takes the initiative if given an opportunity. A child becomes highly curious about various things and may ask trivial questions which if treated as nuisances may result in severe embarrassment and guilt. Excessive criticism and control over the initiatives they take can also lead to guilt development. Too much guilt may hinder creativity and interactivity. The author states that perfect balance between initiative and guilt is necessary for the development of a worth of purpose (McAdams & Zapata-Gietl, 2015). During this stage of life, children may develop, several non-normative behavioral problems are common. Self-harming behavior, inappropriate social behavior, self-stimulatory behavior and lack of life skill are all considered red-flags traits and need early attention and professional consultation ("Red Flags — for children birth to six years", 2016).
Self-esteem, self-concept, and self-identity all are evenly important attributes during the relevant age group. From 3 years, onwards an individual develops a concept of self, starting to identify various physical and characteristics that define them. However, moral or psychological interpretations are yet to develop. Development of personal feelings and thoughts may occur during this period. Encouragement concerning decision-making abilities and self-created activities may grow a sense of self-esteem and efficacy. Ability to cope with challenging situations may affect the self-esteem of a child. Positive feedback from parents, caregivers and teachers can enrich self-esteem and sense of worth. Development of self-identity in the context of culture religion, ethnicity, etc. is highly variable and depends on parenting and nursing practices provided to the child. A low self-esteem and self-identity may cause complications and result in psychological stress (Harter, 1993). A more complex psychology develops once the child begins a comparison of self to the society or the outside world. This may decrease or cause fluctuations in the self-esteem of the individual. Physical activity and fitness have shown to increase the quality of life and consequently the self-esteem and self-efficacy (Joseph et al., 2014). A healthy diet and engaging the child in physical activities in case he/she is reluctant to do so must be the focus of parenting and nursing practices.
As the child develops several new concepts and ideas during this age, proper guidance and careful concept framing parenting practices must be followed. Cognitive aspects of understanding, perception, and awareness play a major role in evolving a proper self-identity and self-esteem. A low self-esteem from this very early age may end up causing severe psychological issues and even depression. There may be diverse reasons behind the incidence of non-normative behavioral transitions. Abuse of any sort can be a driving factor. When the parents or caregivers fail to protect and care for the child or the child is hurt intentionally it is considered that the child is a victim of abuse. It can lead to long-lasting negative consequences. Abuse can cause aggressive or regressive behaviors, depression or withdrawal from social interactions. The emotional condition of the child is severely disturbed, and the parents must identify the unpredictable behavioral transitions at an early stage and take necessary steps to prevent any long-standing consequence.
The Nursing and Midwifery Board of Australia (NMBA), proposes specific standards for the practice of nursing and emphasizes on employing those standards for appropriate professional conduct. Among the various standards, the following are of utmost relevance to our topic of interest: thinking critically and analyzing nursing practices, developing plans for nursing and providing safe, appropriate and responsive quality nursing practice ("Nursing and Midwifery Board of Australia - Professional standards", 2016). The diversity and subjectivity of children of the concerned age group encourage in practicing a person-centered nursing approach. Following the Clinical Thinking Cycle appropriate information and cues must be collected regarding the developmental issues of a child and recognize the areas that need attention. Accurate documentation of the planning, decision-making, actions and evaluation of nursing is needed after careful avoidance of cultural bias. developing nursing practice plans is essential after considering the assessment data, the available resources and a particular motive of achieving the desired outcomes. Goal-directed actions are to be taken with utmost care and safety. The nurse should always take into consideration the sensitivity of the relevant age group, as an individual develops certain traits at this age, which is going to be a determinant of the future psychological framework of the individual. The cultural and social milieu is also relevant in this context.
To summarize, childhood development remains a matter of great concern for parents in general. A clear understanding of child psychology is a fundamental requirement of parenting or nursing a child in the preschool period. An improper handling of childhood issues may result in adverse consequences in later stages of life. Nurses taking care of children must be made aware of the distinct needs required for the specific purpose and importance of managing non-normative aspects with extra care. Finally, a balanced cooperation between the parents, caregivers, and nurses is a prerequisite for serving the aimed cause.
Erikson, E. H. (1984). Reflections on the last stage—and the first. The psychoanalytic study of the child.
Harter, S. (1993). Causes and consequences of low self-esteem in children and adolescents. In Self-esteem (pp. 87-116). Springer US.
Joseph, R. P., Royse, K. E., Benitez, T. J., & Pekmezi, D. W. (2014). Physical activity and quality of life among university students: exploring self-efficacy, self-esteem, and affect as potential mediators. Quality of Life Research, 23(2), 659-667.
McAdams, D. P., & Zapata-Gietl, C. (2015). Three strands of identity development across the human life course: Reading Erik Erikson in full. The Oxford handbook of identity development, 81-94.
Mischel, T. (Ed.). (2013). Cognitive development and epistemology. Academic Press.
Nursing and Midwifery Board of Australia - Professional standards. (2016). Nursingmidwiferyboard.gov.au. Retrieved 10 September 2016, from http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
Piaget, J. (1964). Part I: Cognitive development in children: Piaget development and learning. Journal of research in science teaching, 2(3), 176-186.
Red Flags — for children birth to six years. (2016). http://www.healthunit.org/. Retrieved 10 September 2016, from http://www.healthunit.org/professionals/redflags/Red-Flags-Guide.pdf
TAMMELIN, T., VIIKARI, J. S., & RAITAKARI, O. T. (2014). Tracking of physical activity from early childhood through youth into adulthood.
Zhou, Z., Ren, H., Yin, Z., Wang, L., & Wang, K. (2014). A policy-driven multifaceted approach for early childhood physical fitness promotion: impacts on body composition and physical fitness in young Chinese children. BMC pediatrics, 14(1), 1.
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