Guidepost 1 How do children's bodies change between ages 3 and 6, and what are their nutritional and dental needs?

• Physical growth increases during the years from 3 to 6, but more slowly than during infancy and toddlerhood. Boys are on average slightly taller, heavier, and more muscular than girls. Internal body systems are maturing, and all primary teeth are present.
• Preschool children generally eat less for their weight than before--and need less--but the prevalence of obesity has increased.
• Tooth decay had decreased since the 1970's but remains a problem among disadvantaged children.
• Thumb-sucking can safely be ignored unless it continues beyond age 4, when permanent teeth begin to develop.

Guidepost 2 What sleep patterns and problems tend to develop during early childhood?

• Sleep patterns change during early childhood, as throughout life, and are affected by cultural expectations.
• It is normal for preschool children to develop bedtime rituals that delay going to sleep. Prolonged bedtime struggles or persistent sleep terrors or nightmares may indicate emotional disturbances that need attention.
• Bed-wetting is common and is usually outgrown without special help.

Guidepost 3 What are the main motor achievements of early childhood and how does children's artwork show their physical and cognitive maturation?

• Children progress rapidly in gross and fine motor skills and eye-hand coordination, developing more complex systems of action.
• Handedness is usually evident by age 3, reflecting dominance by one hemisphere of the brain.
• Stages of art production, which appear to reflect brain development and fine motor coordination, are the scribbling stage, shape stage, design stage, and pictorial stage.

Guidepost 4 What are the major health and safety risks for children?

• Although major contagious illnesses are rare today in industrialized countries due to widespread immunization, preventable disease continues to be a major problem in the developing world.
• Minor illnesses, such as colds and other respiratory illnesses are common during early childhood and help build immunity to disease.
• Accidents, most commonly motor vehicle injuries are the leading cause of death in childhood in the United States. Most fatal nonvehicular accidents occur at home.
• Environmental factors such as exposure to illness, smoking, poverty, and homelessness increase the risk of illness or injury. Lead poisoning can have serious physical, cognitive, and behavioral effects.

Guidepost 5 What are the causes and consequences of child abuse and neglect, and what can be done about it?

• The incidence of reported maltreatment of children has increased greatly.
• Forms of maltreatment are physical abuse, neglect, sexual abuse, and emotional maltreatment.
• Characteristics of the abuser or neglecter, the victim, the family, the community, and the larger culture all contribute to child abuse and neglect.
• Maltreatment can interfere with physical, cognitive, emotional, and social development, and its effects can continue into adulthood. Still, many maltreated children show remarkable resilience.
• Preventing or stopping maltreatment may require multifaceted, coordinated community efforts.