A preschooler seems born to help. He has developed many of the necessary motor skills to help you and himself and to perform a variety of everyday tasks. He'll help you unload the groceries, fold the laundry, pay the bus fare. He'll put on his own clothes and shoes, brush his own hair, wash his own hands. He may not do any of it to your standards or schedule, but he'll work with great pride of purpose whenever you let him try. Celebrate that independence, and help your preschooler to help himself.
Your preschooler still needs your help with brushing his teeth. Once a week, you might like to have your child brush his teeth and then chew a disclosing tablet that will colour the plaque and tartar that he missed. It's an entertaining way to teach him proper brushing technique. You should ensure that your child brushes no more than two times a day with fluoridated toothpaste, and use water only or non-fluoridated toothpaste the other times.
Some children begin losing their baby teeth as early as their fourth year, others not until their sixth year. Your child may be quite alarmed by the fact that his teeth have begun to fall out -- it can be a little painful to lose a tooth, and there is sometimes a small amount of blood. For a child who hasn't yet developed a concept of money, the promise of the tooth fairy's visit makes no difference whatsoever. As soon as you notice your child's wiggly tooth, explain that the tooth will soon fall out but it will be replaced with a grown-up tooth that's already in his mouth.
Learning to use the toilet
Now is the time to put away those daytime diapers. Diapers and disposable training pants keep the child feeling dry so it's more difficult for him to relate his bodily functions to the wet result. During the day, put your child in cotton underwear. Let him know that it's OK if he has an accident and that there are fresh clothes that he can put on. Show him where to find clean underwear, pants, and socks. Avoid training pants because they can be difficult to pull on and off.
By this age, most children stay dry during the day, but still have problems making it through the night, even at the age of four. Let him wear diapers or disposable training pants at night until he's dry most nights.
When your child won't use the toilet
Try to view the toilet from your child's perspective. First, he has to climb up on this huge hole into which he then lowers a very vulnerable part of his body; when he's finished his business, he has to push a lever which causes a loud, sucking noise, and whatever was in the toilet completely disappears! Children may fear being flushed down the toilet or having a monster sneak up through the toilet and grab them. They also may feel sad at letting something of themselves get flushed away. To a child, feces or urine may not be unpleasant; they are something he produced, something that was a part of him; giving them up isn't always easy.
When a child is struggling to stay in control, she may refuse to have a bowel movement. This retention of feces will cause her considerable discomfort and even infection if extended to the extreme. Sometimes, explaining the bodily needs of nutrition and elimination, of how her body uses food and eliminates what it doesn't need in poo and pee, can help a child understand why she should excrete urine and feces.
Public washroom dilemma
Even when your child uses the toilet at home, she may not be willing to use a public toilet. The unfamiliarity of a public washroom can be frightening. The toilets themselves are big and they make loud echoing noises when they're flushed. One three-year-old frustrated his parents by wanting to stuff a public toilet with toilet paper each time he used one. After some questioning, he explained that the toilet paper would block out the monsters. With his parents' explanation of how toilets work and with some reassurance, he gradually accepted that there couldn't be any monsters living in the toilets.
• Teach your child, especially a daughter, how to use toilet paper appropriately and to wipe her bottom from front to back.
• Model appropriate hand-washing after wiping oneself and flushing the toilet. Assist the child in handwashing, if necessary.
• Keep up the daily bathtime -- most active children need a thorough clean-up at least once a day.
• Make a bedtime story part of the nighttime routine. The promise of a story after the bath will get the most reluctant bather into the water, and the most committed water-baby out.
• Choose clothing that's easy for your child to manage: shoes that slip on or that have Velcro closures instead of laces; pants and skirts with elastic waists.
• Store her clothes so she can easily find them: one drawer for socks and underwear, one for T-shirts, one for trousers.
• If you want your child to pick up after herself, make it easy: Put coat hooks where she can reach them; put a shoe tree in her closet; place a laundry hamper in her room.
• Respect your child's colour and fabric preferences.
• On those occasions when you don't want to rely on your child's fashion sense, offer a choice of clothing: "Would you like to wear the green T-shirt or the yellow T-shirt with your grey pants?" Offer your child freedom of choice, but within a controlled set of choices. This technique works well in a variety of situations.
Visiting the doctor
In preschool, daycare, and playgrounds, a preschooler comes into contact with many more children. It's not unusual for them to get back-to-back colds during this stage. If you're anxious about your child's health but you're not sure that a trip to the doctor is necessary, call your child's doctor to discuss the symptoms. Sorting the problem out by phone may avoid an unnecessary visit to the doctor. Depending on the symptoms, the doctor may want to see the child -- once she has consulted with you on the phone, she bears some responsibility for the outcome of any suggested treatment.
Have your child's vision tested before he begins kindergarten. About 15 per cent of preschool-age children have a vision problem. The earlier such problems are detected, the greater the chance they can be corrected and sometimes even reversed. Routine hearing tests, on the other hand, are not recommended for preschoolers unless you have a particular concern.
Medical conditions like asthma or allergies usually emerge by the time a child is five years old. If your doctor diagnoses these problems, she may refer you to a specialist. Similarly she may refer your child for assessments if she sees indications of speech, language, and learning disorders. Regular check-ups with your family physician are still important for assessment of your child's growth, for booster vaccinations, complete physical exams, review of nutrition, and guidance about changes to expect.