What’s Normal And When To Worry
What’s Normal And When To Worry
You may wonder if your little one is developmentally “normal” for a Singapore child, but when should you actually worry? We poll the experts for what to look out for during the preschool years.
2 years old
WHAT TO EXPECT
Your little one would have started to talk by now and is curious and inquisitive, says Dr Cynthia Lim, a senior lecturer at the Singapore University of Social Sciences.
He is physically active and keen to explore the world around him. At this age, he can also point to pictures in books and make connections between these and real-life objects.
He enjoys make-believe play and his symbolic understanding is developing – for example, he may hold up a banana to his ear and pretend it’s a phone.
PARENTING CHALLENGES
Two- year-olds aren’t aware of some of the dangers associated with playing, so you have to keep a close watch on them, Dr Lim says.
They may want to do things on their own, but they’re also dependent on you, so it’s important to try and strike a balance between the two.
“Other parenting challenges include learning how to handle your two-year- old child’s temper tantrums, dealing with separation anxiety, and introducing them to new activities, foods and experiences,” adds Dr Low Kah Tzay, a paediatrician at Pediatric Doctor by Anson International Paediatric & Child Development Clinic.
BOOST YOUR KID’S DEVELOPMENT
Social interaction with adults is crucial because this is how they learn, says Dr Lim.
It’s also important to do things with them rather than just show or tell them what to do. At this age, you should let your child play freely and explore nature.
“As your child is picking up new words every day, I suggest talking to him normally instead of using baby talk,” says Dr Lim.
“And limit his use of mobile devices as excessive use may impede his language and social development – these are fine once in a while if you interact with him using the device as joint engagement rather than as a babysitting tool.”
BEST TOYS
Dr Low suggests building blocks, shape sorters, and toys that he can manipulate and use to create other objects.
WHEN TO SEEK HELP
While your toddler should be starting to talk at two, don’t be too quick to label him as having learning delays, as children develop at different rates.
If he doesn’t seem to be saying much, continue to talk with, interact and engage him in things he is interested in and just keep an eye on his speech development, says Dr Lim.
“It would be concerning if your child isn’t gesturing at people and objects and doesn’t respond when you try to interact with him,” she adds. “And you may wish to seek help if he’s not running or walking at this age.”
In addition, while not a real problem, look out for signs of overstimulation in your child, especially if your family has a hectic lifestyle and your child is constantly on the go, Dr Lim says.
An overscheduled child may show signs of tiredness and fussiness and may be more easily prone to illness. Some kids are also more sensitive to sensory overload like big crowds, loud noises and bright lights – they are easily distressed.
What you need to know about Global Development Delay
According to Dr Low Kah Tzay, a paediatrician at Pediatric Doctor by Anson International Paediatric & Child Development Clinic, child development is divided into four aspects:
GROSS MOVEMENT such as walking, jumping and running.
FINE MOVEMENT such as holding a spoon or a pen and handling buttons and zips.
LANGUAGE Being able to say words or form sentences.
SOCIAL Knowing how to interact and socially adapt, knowing when to be silent, and being able to pay attention, take turns and share.
“Global development is when there’s a delay in all these four areas,” Dr Low says. “It signifies a serious medical condition and should be assessed to work out whether it is static or progressive.”
Treatment may include dealing with any underlying medical conditions, speech therapy for language, physiotherapy for movement, occupational therapy for fine movement or organisation, and behavioural therapy for social adaptation, Dr Low adds.
See a paediatrician if you suspect that your kid has this condition.
3 years old
WHAT TO EXPECT
Junior should be able to speak in short sentences, answer when his name is called, identify common objects, ask questions, follow simple instructions, and feed himself with his fingers and a spoon, Dr Low says.
You should also notice signs of social and emotional development, says Dr Sanveen Kang- Sadhnani, clinical psychologist and centre manager at Thomson Paediatric Centre – The Child Development Centre.
For example, he may share his toys and volunteer for tasks, accept friendly teasing, express anger in words rather than actions, and show empathy towards others. Physically, your three-year-old should be able to jump over low objects, gallop, and tiptoe.
PARENTING CHALLENGES
You may find it challenging setting boundaries and getting preschooler to follow them, as well as making sure he’s physically safe at all times, since he may still be trying to understand what’s dangerous and what’s not, Dr Low says.
Disciplining (and explaining the concept of discipline) is also important, as he may have certain preferences and often starts expressing himself at this age.
You may also already have begun toilet training, which brings its own set of challenges.
BOOST YOUR KID’S DEVELOPMENT
Communicate with your three-year-old regularly because he still requires plenty of interaction at this age, Dr Low says. Ask him questions such as what he likes or how he does certain things, and initiate conversations around simple topics.
“You should also encourage and guide decision- making at this age, and get him to read displays and directional signs,” Dr Low adds.
BEST TOYS
Your child will benefit from playing with construction blocks, doing art and craft related activities, drawing, and using colouring books, Dr Low says. He may also enjoy playing with musical instruments such as drum sets.
WHEN TO SEEK HELP
If your little one is unable to string two or three words together, or repeats or “parrots” questions instead of answering them, then it may be a sign of developmental delay.
In addition, says Dr Low, you should be concerned if your three-year-old is unable to jump and finger- feed himself.
Helping your child develop intellectually is important, but don’t just focus on academics at this age.
4 years old
WHAT TO EXPECT
By age four, your preschooler should be able to match a number of items to the correct numeral, recognise a few printed words, print his first name without a model, and predict what will happen next, Dr Kang-Sadhnani says.
He should also show signs of development in communication. For example, he should be able to tell familiar stories without picture cues, participate in group discussions, and respond to questions involving time concepts (such as, “When did you eat lunch?”).
Dr Kang-Sadhnani adds that your four-year-old should be able to do things like:
• Bounce and catch small balls, like a tennis ball
• Colour within the lines
• Cut out a square
• Brush or comb his hair
• Brush his teeth without assistance
• Select clothing that’s appropriate for the climate and occasion, and
• Use the toilet on his own and be able to flush and wipe himself when he is done.
When it comes to social and emotional development, Dr Kang-Sadhnani says that your child should know to say “excuse me” if he wants to politely interrupt a conversation; offer assistance to others and help with group projects; as well as respond appropriately in social situations.
PARENTING CHALLENGES
This is the age when kids start developing moral values – so they may lie to get their way.
They may also be able to tell if you’re practising double standards, so it’s important to be aware of this and maintain consistency in what you do and say in front of your four- year-old.
At this age, your kid should also be developing in his ability to tell reality from non-reality, and danger from non-danger. As a result, he may show and develop fear in certain circumstances.
BOOST YOUR KID’S DEVELOPMENT
Helping your child develop intellectually is important, but don’t just focus on academics at this age.
Non-educational enrichment classes like gymnastics or swimming are also recommended, and Dr Kang-Sadhnani says that playtime, both alone and with other children, will keep your little one engaged and stimulated.
BEST TOYS
Four-year-olds will benefit from playing with toys and games that bring out their creative side and that they can manipulate and explore. It’s also important for them to participate in activities that challenge them physically and allow them to interact with other kids.
WHEN TO SEEK HELP
Dr Kang-Sadhnani says to look for delays in cognitive development – for example, if your child has trouble understanding concepts like same and different, heavy and light, and so on.
The same goes if he cannot retell a story from a picture book, cannot copy his own name, or cannot match objects that have the same function.
You should also be aware of delays in communication – he can’t tell how simple objects are used and can’t answer questions when told a short story, for instance.
Other red flags: Social and emotional issues such as a lack of empathy for others and an inability to quieten down after active play; and delays with physical development.
5 years old
WHAT TO EXPECT
Typically, five-year-olds in the Singapore preschool system are taught to identify simple words and write their names, Dr Lim says.
They should have well developed motor skills, in that they should be able to throw and catch balls, ride a bicycle and dress themselves.
They also should be able to try tying their shoelaces, use a pair of scissors reasonably well, and draw – their ability to represent objects like houses, flowers and cars in their drawings, based on what is prominent in their minds, allows adults to recognise what they are trying to communicate.
PARENTING CHALLENGES
“Your five-year-old may try to push boundaries and negotiate with you, and some children can exhibit stubbornness or defiance at this age,” Dr Lim adds.
“You should be clear with your child about what can be negotiated and what can’t.”
In addition, understand your kid’s temperament and try to work with it.
Some children also develop fears (due to past experiences or nightmares) – for instance, they may tell you that they’re afraid to go to sleep or be alone in their room because of monsters under their bed.
You may need to let your kindergartener talk about his fears and give him support and gentle reassurances instead of glossing over his fears as “silly thoughts”.
Hyperactivity is common in kids this age – some children may have shorter attention spans than others, but Dr Lim warns against labelling this behaviour as a condition too early.
Watch your child’s sugar intake as well, as this may cause energy spikes.
BOOST YOUR KID’S DEVELOPMENT
“It’s important for your child to interact with kids his age,” Dr Lim says.
“Not only will this help develop his social skills; he’ll also understand the concept of cooperative play and learn how to negotiate rules and manage conflict.”
Your child may be busy with enrichment activities and school, but downtime is just as important because kids need to de-stress too, she adds.
BEST TOYS
Dr Lim suggests simple jigsaw puzzles, board games, and open- ended creative toys like Lego that allow kids to create simple objects and build small structures.
Your five-year-old may also take a liking to fancy stationery and stickers. Allowing kids this age to engage in craftwork may bring out their creative side.
WHEN TO SEEK HELP
Some signs to look out for, according to Dr Lim, include an inability to copy letters or shapes, identify numbers or count things.
By this age, your child should also be quite a strong communicator and able to express his feelings and thoughts.
If your little one is not shy, but shows no interest in social interactions all the time, you may want to seek a professional opinion on his social and emotional development.
On the other hand, if your five-year-old exhibits aggressive behaviour, you may need to find out if he is experiencing issues such as frustration, neglect, unresolved conflicts or chronic stress. He may also be experiencing or modelling violence, or reacting to protect himself against bullies.
6 years old
WHAT TO EXPECT
By this age, your kid should know his day and month of birth, write his first and last name from memory, state the use of at least three body parts, and be able to count up to 20 objects and read more than 10 words, says Dr Kang- Sadhnani.
His communication skills would also be more developed – he should be able to tell simple jokes, identify the left and right sides of his body, and use words like “yesterday” and “tomorrow”.
“When it comes to physical development, six- year-olds should also be able to drop a ball and kick it forward before it hits the floor, cut out simple geometric shapes, skip, and dribble an eight- to 10- inch ball using one hand,” Dr Kang-Sadhnani adds.
Your preschooler may also apologise if he’s hurt someone’s feelings, will remain calm when small requests are denied, and manage to answer the phone and remember simple messages – these are all signs that his social and emotional development is on the right track.
Independence is another sign to look out for – he should be able to shower on his own, prepare simple meals, and set and clear the table without assistance.
PARENTING CHALLENGES
The issues you experience with your six-year-old are similar to the ones you would have experienced when your kid was five, Dr Lim says.
You may have to deal with a child who is temperamental or acts up in order to get his way, and who may try to test your boundaries and negotiate with you.
BOOST YOUR KID’S DEVELOPMENT
As with five- year-olds, it’s important to ensure that Junior has plenty of social interaction with his peers, and gets sufficient downtime in-between school and all his enrichment activities, Dr Lim says.
BEST TOYS
Dr Kang- Sadhnani recommends a mix of traditional toys, toys that allow your kid to play pretend, toys that bring out their creativity, toys that involve play and cooperation with others, and toys that challenge them physically.
WHEN TO SEEK HELP
If your six-year-old has trouble reading and writing simple words and doesn’t know how to count even a small number of objects, you may want to seek professional advice.
In addition, as with five-year-olds, you should be concerned if your child acts aggressively, has a bad temper, is unable to get along with his peers most of the time, and cannot do simple tasks independently.
As your six-year-old becomes independent, he may act up in order to get his way, or test your boundaries and negotiate with you.
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