SYLLABUS OF THEORY 4 PHYSICAL DEVELOPMENT, NUTRITION, NURSING & WELFARE OF CHILDREN. Unit 2 PARENTING & HEALTH CARE NEEDS OF CHILDREN 4-5

Pre Home Assignments

Learning Activity 1: Book Reading & Review Writing: Read minimum one book related to Parenting & write reviews in Theory Assignment Book in 2 A 4 pages (each book).

Learning Activities for Live Class Session:

Learning Activity 1: Pair Practice: Two pupils sit face to face and share their school experiences relating to diseases — infected in their life or their family member’s life and the treatment made pertaining to. All the pairs are practicing at the same time.

Learning Activity 2: Teaching & Learning through Puppetry: Teach the children the importance of keeping public places neat & clean via puppetry & puppet drama. Give chances to 3 or 4 trainees for presentation.

Learning Activity 3: Discussion: Arrange a discussion by forming trainees into 6 member groups regarding parenting. The group leader should present the highlights of the debate to the mass. The findings from the discussion should be written in two A4 pages in the Theory Assignment Book.

Learning Activity 4: Pair Debate: Two pupil’s sit face to face and talk about the health care activities following in their nearby school.

Learning Activity 5: Group Discussion: Arrange a Group Discussion like in TV. All students are participating in the discussion.
Round 1: Purpose and objectives of learning and practicing the content in this theory unit
Round 2: How to apply the knowledge and the ideas in this unit in your life, career and in society.

Learning Activity 6: Learning activity as per students’ choice. Conduct a learning activity as per the choice of lesson activities coordinating group.

Self-Home Assignments & with classmates:

Learning Activity 1: Self Speech in front of Mirror: Do a Self-Speech about Effective Parenting in front of the mirror by following all the formalities and techniques of public speech.

Learning Activity 2: Pair TV Interview with a Health Worker: One takes the role of a Health Worker and the other one takes the role of an anchor. Sub: Health care and other dietary needs of children. Faculty prepare the list & put it in the group.

Learning Activity 3: Self Speech in front of Mirror: Do a Self-Speech about physiological & social emotional needs of children in front of the mirror by following all the formalities and techniques of public speech.

Individual & pair learning activities as Post Home Assignments:

Learning Activity 1: Parenting: Implement the parenting related ideas & tips mentioned in this unit in your family. Write your experience & results in 2 A4 pages in your Theory Assignment Book.

Learning Activity 2: Story Making and writing: Make a Mini story related to children of your own and write it in English in your Theory Assignment Book.

Learning Activity 3: Community Poster making, in a manual way with children’s rights and health related topics in an attractive way with pictures and get pasted in public places.

Introduction

Health care involves looking after the child’s physiological, socio emotional and cognitive needs. Neglecting in one aspect is likely to hamper the other aspects of development. Given further are the physiological and socio-emotional needs of children in the age group of 3-6 years with special reference to health care of the body.

PARENTING

The goal of parenting is to teach kids to develop self-discipline. When parents learn and apply the three Fs of Effective parenting techniques on this page and others, they find that yelling, screaming and spanking disappear and a positive relationship is established.

Guidelines for Parent Child Relationships:

1. Try to set aside time on a regular basis to do something fun with your child.
2. Never disagree about discipline in front of the children.
3. Never give an order, request, or command without being able to enforce it at the time.
4. Be consistent, that is, reward or penalty the same behavior in the same manner as much as possible.
5. Agree on what behavior is desirable and not desirable.
6. Agree on how to respond to undesirable behavior.
7. Make it as clear as possible what the child is to expect if he or she performs the undesirable behavior.
8. Make it very clear what the undesirable behavior is. It is not enough to say, “Your room is messy.” Messy should be specified in terms exactly what is meant: “You’ve left dirty clothes on the floor, dirty plates on your desk, and your bed is not made.”
9. Once you have stated your position and the child attacks that position, do not keep defending yourself. Just restate the position once more and then stop responding to the attacks.
10. Look for gradual changes in behavior. Don’t expect too much.
11. Praise behavior that is coming closer to the desired goal.
12. Remember that your behavior serves as a model for your children’s behavior.
13. If one of you is disciplining a child and the other enters the room, that other person should not step in on the argument in progress.
14. Reward desirable behavior as much as possible by verbal praise, touch or something tangible such as a toy, food or money.
15. Both of you should have an equal share in the responsibility of discipline as much as possible.

The “3 Fs” of Effective Parenting:

1. Firm: Consequences should be clearly stated and then adhered to when the inappropriate behavior occurs.

2. Fair: In the case of recurring behavior, consequences should be stated in advance so the child knows what to expect. Using a simple Time Out can be effective when it is used consistently every time the behavior occurs. Also, use of reward for a period of time like part of a day or a whole day when no Time Outs or maybe only one Time Out is received.

3. Friendly: Use a friendly but firm communication style when letting a child know they have behaved inappropriately and let them know they will receive the “agreed upon” consequence. Encourage them to try to remember what they should do instead to avoid future consequences. Work at “catching them being good” and praise them for appropriate behavior.

The Parent as Teacher / Coach

See your role as that of a teacher or coach to your children. Demonstrate in detail how you would like them to behave. Have them practice the behavior. Give them encouragement.

1. Rather than tell them what not to do, teach and show them what they should do.
2. Try to set aside time on a regular basis to do something fun with your children.
3. Use descriptive praise when they do something well. Say, “I like how you ____ when you ____.” Be specific.
4. Help your child learn to express how he feels. Say: “You seem frustrated.” “How are you feeling?” “Are you upset?” “You look like you are angry about that.” “It’s O.K. to feel that way.”
5. Try to see a situation the way your children do. Listen carefully to them. Try to form a mental picture of how it would look to them.
6. Use a soft, confident tone of voice to redirect them when they are upset.
7. Be a good listener: Use good eye contact. Physically get down to the level of a small child. Don’t interrupt. Ask open ended questions rather than questions that can be answered with a yes or no. Reciprocate back to them what you heard.
8. Make sure they understand your directions. Have them repeated back.
9. When possible give them choices of when and how to comply with a request.
10. Look for gradual changes in behavior. Don’t expect too much. Praise behavior that is coming closer to the desired goal.
11. Develop a nonverbal sign (gesture) that your children will accept as a signal that they are being inappropriate and need to change their behavior. This helps them to respond to your prompt without getting upset.

The Use of Reward in Positive Parenting

1. Whenever possible try to use reward and praise to motivate your child to improve their behavior.

2. For younger children you can use “grandma’s rule.” Say, “When you have picked up all your clothes, you may go out and play.” Be sure you use “when” rather than “if.”

3. Combine reward with time out for serious disruptive or defiant behaviors. Say, “Every time you ____, you will have a ____ time out. If you can go the whole (day, afternoon, etc.) without getting a time-out, you will earn ____..

The First Time Club

1. If you are having trouble getting your child to do something when you ask, have him become a member of “The First Time Club.”

2. Make up a chart with 30 squares. Tell the child that each time he does something the first time he is asked, a happy face will be placed in a square. When all the squares are completed, he will earn a reward.

3. Mutually agree on the reward. For younger children, you can place a picture of the reward on the chart or for older children you can write it on the chart.

4. Then practice with the child how he is to behave. “Each time I ask you to do something, I want you to: (1) Use good eye contact, (2) Listen quietly, (3) Say OK I will ____. Then (4) Do it.” Practice this, making a number of requests.

5. Then start the program. Be sure to praise him for each success during practice as well as when the program starts. By the time the squares are filled, he will have developed a new habit. When he completes the program, provide the reward immediately. Take the chart down and let him have it as part of the reward. Continue to use praise and encouragement to make sure this new habit remains and becomes even stronger.

The Family Chip System

If your child is having a lot of difficulty in getting along at home, consider using the “Family Chip System.” This is a very powerful tool. When used consistently, most children will show great improvement within a few weeks’ time. The program provides immediate reward for appropriate behavior and immediate consequences for inappropriate behavior. By the way, if you have other children around the same age as the child for whom you are designing this program, put them on the program as well. Children really like this system. Parents love the system.

Here are the steps to follow to use this program with your child:

A. Purchase a box of poker chips from the drug store.

B. Hold a family meeting to discuss the need for the program. Tell the children that it will help them to learn to be in charge of themselves. You can tell older children that this system is similar to what adults experience: (1) Adults earn money for working; (2) Adults have to pay fines for breaking rules like speeding or make a late payment; (3) Adults spend their money on things they need as well as a few things they want.

C. Develop a list of behaviors that will earn chips for. Start with the morning and then go throughout the day looking for behaviors to get rewarded. These can include positive attitude, self-help behaviors and chores. If you are using a behavior modification program for school you can give them chips for each point earned on that system. Some possibilities are: getting up on time, brushing teeth, getting ready for school on time, playing nicely with brother or sister, completing chores such as feeding a pet or taking out the trash, saying please and thank you, doing things the first time they are asked, doing homework without a fuss, getting ready for bed on time, going to bed on time, cleaning bedroom.

D. Agree on a list of behaviors that will result in loss of chips. These can include behaviors that are oppositional, defiant or disruptive. Some examples are: tantrums, yelling, screaming, fighting, arguing, throwing things, jumping on the furniture, getting up after bed time, swearing, putting others down. (Some more serious behaviors will receive a Time Out plus a fine).

E. Agree on a list of privileges they will earn and pay for with chips. Some privileges will be bought for the day, others will be bought for a period of time (usually 1/2 hour). These can include: watching TV, playing outside, computer time, renting their bike or other large toy, playing a game with a parent, etc. Practice giving and receiving chips before starting the program. The practice should be based on the rules for parent and children provided below:

Rules for Parents When Giving Chips:

a. Be near your child and able to touch him (not 20 feet or two rooms away).
b. Look at your child and smile.
c. Use a pleasant voice tone.
d. Make sure your child is facing you and looking at you.
e. Praise your child “Hey that’s great. You’re really doing a nice job. That’s really helping me.” Reward your child with chips. “Here’s 2 chips for doing a great job.”
f. Describe the appropriate behavior for your child so he knows exactly what behavior he is being praised and rewarded for.
g. Hug your child occasionally or use some other form of positive touch.
h. Have your child acknowledge you, such as, “Thanks Mom” or “Okay.”

Rules for Parents When Taking Away Chips:

a. Be near your child and be able to touch him.
b. Look at your child and smile.
c. Use a pleasant voice tone.
d. Make sure your child is facing you and looking at you.
e. Explain what was inappropriate such as “Remember you are not allowed to run in the house because it is not safe.” “You need to learn not to yell and scream so we can enjoy being together at home.”
f. Be sympathetic. “I know it’s hard to lose chips but that’s the rule.”
Give your child the chip fine.
g. Make sure your child gets the chip appropriately.
h. Prompting the appropriate responses will sometimes be necessary. For example, “Come on, give me a smile–That’s right.”
i. If a chip loss is taken very well by your child, it is a good idea to give him back with a chip or two.
j. If your child is too mad or upset to give you the chips, don’t force it. Place your child in time out (to cool off) and then get the chips.

Rules for Children When Getting Chips:

a. You should be facing your parents, looking at them and smiling.
b. You should acknowledge the chips by saying “O.K.,” “Thanks,” or something else pleasant.
c. The chips should be put in a specified container. (Any chips left lying around are lost.)

Rules for Children When Losing Chips:

a. You should face your parents, look at them and smile (not frown.)
b. You should acknowledge the chip loss with “O.K.” or “All right,” “I’ll get the chips,” etc. (You must keep looking at them and be pleasant).
c. You should give the chips to your parents pleasantly
d. Post the list of behaviors and chips earned in a convenient place.
e. Let your child decorate a paper cup in which to keep their chips. Place the “bank’s” chips in a jar or bowl and put it in a place that is out of reach of children.
f. Start using the program. Feel free to modify the program at any time by holding a meeting. Sometimes point values need to be raised or lowered to achieve a goal. You may add or remove items from the list as well.
g. After about 6 weeks, you may be able to start short trials off the system. Say, “Today we are going to try not using the chip system. If things go well we will try it again the next day.” If the trial is successful, continue for about a week. If things continue to go well, hold a meeting and celebrate all that you and your child have both gained from the system. If your child is not ready, continue with the program.

Note: If your child runs out of chips, have a list of extra chores they can do to earn chips so that they remain on the system.

PHYSIOLOGICAL NEEDS

1. Food and Water: These basic needs should not only account for the child’s survival but also for his/her development. Most of you would be familiar with the functions of food and water. Food provides energy for work, helps in the growth and maintenance of the body, protects from diseases and serves a psychosocial function too. Water helps in the regulation of many body functions. Adequate amounts of food and water at the right time help the child to stay healthy and happy.

2. Clothing: Suppose you were to present a dress to a 4 year old child. How would you go about it? Proper selection of clothes protects the child from climatic changes. Clothes should be comfortable not only to the delicate skin of the child but should also allow free movement of limbs. Since clothes have cosmetic value too, children feel delighted when their garments have attractive designs and colors.

3. Sleep and Rest: Recall your childhood days. How would you have felt if you were forced to study or play when you were feeling very tired and sleepy – irritable and angry, isn’t it? The child must be allowed to have adequate sleep and rest. This gives rest to the body organs and the child feels fresh on waking up. As children grow older, their requirement for sleep also reduces.

4. Activity and Exercise: Akaash, as a kid, did not get much opportunity to play outdoor games. He is now14. Although otherwise healthy, he gets pain in his leg and arm muscles whenever he plays football. Guess why?
Being at a growing age, the preschool child is very active. Good amount of physical activity and free play is necessary for adequate muscle development. Lack of adequate opportunities of physical activity / exercise can hamper the normal growth of children resulting in growth retardation or malformation in the long run.

5. Hygiene: Most of you would know that personal and environmental hygiene are important contributors to good health. This calls for proper toilet training of the child and care of body organs such as eyes, ears, nose, mouth, teeth, hair, skin and hands. Children should be trained to keep their anal and genital areas clean and to wash their hands thoroughly with soap and water every time after using the toilet.

SOCIO-EMOTIONAL NEEDS

1. Love and security: These are two important factors contributing to a healthy growth of mind. It is essential for a child to have a feeling of being wanted and needed by others. Make a secure feeling that he/she has a certain place in the family and society. Look at the case of Amit. He has developed a jealous feeling towards his younger sister Sibly. Because he feels that his place in the family has been taken over by her. In such a situation, it becomes the duty of the parents to make the elder child understand that it is not so. An understanding, patience and friendly attitude on part of the parent/ teacher along with proper guidance whenever needed contribute strongly in developing self-confidence, a positive self-image, emotional security, adjustment in society and self-control.

2. Independence: At this age, the pre-scholars’ learn to perform independently. Depending upon their ability children should be encouraged to perform tasks as well as think independently. This also helps in developing confidence in the child. Though over – protection should be avoided, one should not go a long way in making the child over-independent too.

3. Socio-emotional environment: A healthy socio-emotional environment is essential for the smooth and healthy emotional development of the child. What a child sees is important. Alcoholism, quarrels at home, racial and class discrimination, antisocial activities and violence in society, all result in feelings of frustration, dejection, fear, non-adjustment in the child and at times may even result in anti-social behavior in the child.

OTHER HEALTH CARE

1. Immunization: A regular immunization schedule needs to be followed since the time of birth of the child as per the immunization chart

2. Health check – up: A regular health check – up of the child should be undertaken and a health record need to be maintained. Health examination should include physical examination, recording of pulse, breathing rate, temperature, measurement of height, weight, chest, abdomen, examination of neck, eyes, ears, nose, throat, teeth, skin, hair, nails, vision, hearing, mental responsiveness, movement of limbs, urine and stool examination etc. This helps in early detection of defects such as defective vision, dental defects etc. Health check should be the duty of parents as well as the school/child care centre/crèche. Any problem diagnosed or reported should be attended to immediately.

3. Safety: Adequate provisions for the safety of children at home or outside are an aspect not to be neglected. Rakesh bought a bow and arrow during Dussehra. While playing carelessly within one day, he accidentally hit the arrow in his younger sister’s eye, damaging her eye forever. Keeping medicines, chemicals, other dangerous items out of reach of children, keeping electrical wires insulated, putting away broken pieces of glass, cleaning of spilled water or oil on the floor, etc. are important steps towards safety. First aid measures should be made available immediately. They should also not be allowed to play dangerous games or burn fireworks alone. Safety measures should also be taken when they travel by vehicles to and from school.

FOOD AND NUTRITIONAL NEEDS

Just like the 0-3 years age group, the 3-6 year old has their nutritional needs. A well-nourished child has normal weight and height as per age, is alert, active, happy and curious, sleeps well at night, is not irritable, has a good attention span, and has a good appetite and normal bowel movements. His/her eyes are clear and bright, hair normal and lustrous, teeth white and clean, skin smooth, slightly moist and glowing, gums firm and pink and posture erect. In order to keep the child properly nourished, it is essential first to understand and then comply with the food and add up nutritional needs of the child of this age. Since nutrients make up each and every cell of the body, keeping up with the nutritional needs becomes important for healthy development of the body and mind. Deficiency, excess or imbalance of nutrients can not only create mild disorders but also can even cripple or kill a person.

DIETARY REQUIREMENTS

The 3-6 year old grows at a steady pace, but is very active at the same time. Hence the nutritional requirements of children depending upon their body size are much higher than those for adults. Though the body needs all the nutrients in required proportions, nutrients more important at this age are Carbohydrate, Protein, Vitamins (A, B, C, D) Calcium, Phosphorus, Iodine and Iron. The energy and protein requirements for 3-6 years age group are given below:
Energy – 1690 kales/day. Protein – 30g/day. Ask your family members what used to be your diet when you were between the age of 3 and 6 years. The pre-scholars’ diet should contain enough cereals and pulses, a variety of vegetables, especially green leafy vegetables and yellow and orange vegetables such as carrot, pumpkin etc., fruits especially guava, citrus fruits like orange, mausambi, amla and yellow fruits such as papaya and mango. Milk should also be given in good amounts, although over emphasis should be avoided. Suppose a child does not take milk. What can be the solution to the problem? Alternative milk products preparations like curd, paneer, custard, cheer, puddings can be used. It is better to prefer jaggery to cane-sugar wherever and whenever possible. During illness, the food choice would depend upon the disease. But an effort should be made to provide easily digestible, highly nutritious, meals during ill-health.

OTHER FOOD HABITS

Have you ever had an opportunity to observe the eating habits of preschoolers’? If not, try to find one. Since your children are sensitive to taste, it is better to avoid strong flavours and too many spices. Too hot and too cold foods should also be avoided. Food should be prepared depending upon the likes and dislikes of the child. The child should never be forced to eat. In order to develop taste, less likeable foods can be offered when the child is very hungry, followed by more likeable foods. By this age, children are able to feed themselves independently, and this should be encouraged. Care should be taken to see that mealtimes are relaxed. Junk food and too many sweet foods should also not be preferred. At the same time, food should not be used as a source of reward or punishment. Care should be taken that the child does not skip breakfast. Children usually enjoy food when all family members/ many children in their centre eat together. Different varieties of food preparation also makes them feel happy.

OTHER HEALTH PROBLEMS

Recall your childhood days. If you are not able to do so, ask your parents, family members. What were the different health problems that you suffered from? The children of preschool age have yet to develop their immunity completely. Apart from nutritional disorders, which you have already learned, a number of factors contribute to ill-health. These are infections resulting from an unclean environment or otherwise, socio-emotional factors such as constant scolding, neglect, isolation, fear, unhappy homes etc. and increased stress and strain which could be physical, social or psychological:

‘Rohit’ suffers from Asthma. His father beats him up if he does not stand first in class. As a result of this, every time during examinations Rohit’s problem of Asthma increases. Whatever the cause, the common health problems or illnesses occurring in children are briefly outlined below:

1. Eye Problems:
a) Infections – Conjunctivitis, Stlye.
b) Allergies
c) Defects- long and short sightedness, squint
d) Injuries.
e) Foreign bodies.

2. Ear Problems:
a) Infections- pain, discharge.
b) Injuries
c) Deafness.

3. Tooth Problems:
a) Infections – Dental caries.
b) Malformation of teeth resulting in cavity problems.
c) Injuries.

4. Skin Problems:
a) Infections- Chicken pox, measles, herpes, scabies, head and body lice, leprosy.
b) Allergies- Eczema, heat rash
c) Injuries

5. Respiratory problems:
a) Infections- Bronchitis, pneumonia, T.B., common cold, sore throat, tonsillitis, whooping cough
b) Allergies- asthma, cold, cough.

6. Gastrointestinal Problems:
a) Infections- Cholera, dysentery, typhoid, hepatitis, worm infestations (hookworm, roundworm, tapeworm and threadworm).
b) Indigestion – abdominal pain, diarrhoea, nausea, vomiting
c) Constipation.
d) Intolerance to certain foods.

When Shabana got admitted to a nursery school, she started getting frequent attacks of abdominal pain and fever. The entire test was normal. Medicines showed response, but only temporarily.
Finally the cause was attributed to her new teacher who was constantly scolding the children.

7. Fevers:
a) Fever as a symptom of any infection.
b) Fever due to stress
c) Heat stroke

8. Heart problems, Kidney problems, Blood problems, Nerve problems, and Malaria, Poliomyelitis and Hormonal problems.

9. Accidents: Burns, wounds, fractures, poisoning, drowning, electric shock, bites etc.

10. Disabilities: Physical (visual, hearing, speech or orthopaedic) mental and emotional disabilities

Module Developed by: Baba Alexander

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