陪伴孩子成長的修行路必備手冊（十一）

這是 達醫(yī)曉護 的第 3330 篇文章

上一篇我們介紹四到五歲孩子各階段發(fā)育的科普。本次的主題是接著一起來看看學齡前兒童在五到六歲的正常發(fā)育軌跡，如何促進處于這個階段的兒童發(fā)育，以及在什么情況下需要引起重視去看發(fā)育專科醫(yī)生。

游戲和學習

即使孩子們長大并開始準備上學了，玩游戲對他們來說還是很重要。這仍然是孩子們學習和培養(yǎng)社會交往能力、情感和思維技能的方式。

孩子會玩更復雜的扮演類游戲了，充滿了幻想和戲劇性。你可能會發(fā)現(xiàn)孩子可以和其他人一起玩來實現(xiàn)一個共同的目標——例如，一起建造一座大沙子城堡。如果一起玩的小伙伴不想玩某個特定的游戲，孩子可能也會想辦法自己解決。這個年齡孩子的社交能力在增強，更喜歡和朋友一起玩，而不是自己一個人玩。他們會與人一起分享，盡管可能會發(fā)現(xiàn)很難做到分享自己喜歡的玩具和物品。

對于六歲的孩子來說，需要遵守游戲規(guī)則才能玩的游戲有時具有挑戰(zhàn)性，孩子有時甚至還可能會指責別人作弊。

情感發(fā)展

在這個年齡，孩子們能夠表達自己的感受，盡管有些比較微妙的情緒，諸如挫折或嫉妒等，可能需要在我們的幫助下并花費一些時間才能確認并談論。他們通常能更好地控制自己的情緒，和以前相比，憤怒和悲傷的情緒爆發(fā)在減少。

與以前相比，你會發(fā)現(xiàn)孩子有更多的耐心，甚至可能愿意和你講道理。這意味著從今以后，你和孩子的分歧可能會減少。雖然六歲的孩子開始喜歡獨立，但他們仍然需要你的愛和充分的關注。與你和家人的交流溝通是孩子生活中最重要的事情。孩子會為自己取得的成就感到自豪，并希望得到你的認可——而且不喜歡被批評或管教。

隨著孩子對周圍世界的了解越來越多，可能會導致一些擔心的情緒。例如，一些孩子可能會擔憂害怕超自然的事物（如鬼魂）、批評、考試、失敗或身體上的傷害或威脅。

思維

在這個年齡階段的學齡前兒童集中注意力的時間比以前長些。孩子能理解時間（今天、明天、昨天）等簡單概念，知道季節(jié)，能認識一些單詞，并嘗試讀出來。有些孩子可能會自己閱讀書本。孩子開始善于從別人角度出發(fā)來思考，這有助于他結交和認識朋友。

語言和交流

在這個年齡，孩子們很嘮叨話很多，有時甚至與在房間里沒有人的時候也會說話。你會發(fā)現(xiàn)孩子會使用完整復雜的句子，并進行成人式的對話，但他們可能仍然難以描述復雜的想法或事情。你的孩子會聽懂笑話和謎語——關于便便和小便的笑話對他們來說特別有趣。孩子也會喜歡在學校做“展示和講述”的機會。

孩子理解的單詞比他們能說出來的多，他們每天學習多達5-10個新單詞。這個年齡段的詞匯量增長如此之快，常常會出現(xiàn)孩子的大腦思考的速度往往超過了孩子說話的速度的情況。

運動

五歲的孩子的協(xié)調性更好了，喜歡炫耀新的運動技能——你經(jīng)常會聽到他在叫“快來看我！” 你的孩子可以學習如何騎自行車、跳繩、金雞獨立、不需要牽著你的手下樓、跳躍和接球。許多六歲的孩子還會開始對像足球這樣的團隊運動感興趣。

你家六歲的孩子是不是總是沒法安靜下來？看電視、吃飯甚至睡覺時扭動對他們來說都是很正常的。

孩子的精細運動技能正在提高，這使得他們在系鞋帶、使用筷子，拉鏈和紐扣、梳頭發(fā)等方面變得更加獨立。

在五到六歲這個年齡階段，孩子可能還會：

·會畫不同的簡單圖形

·會寫字母和自己的名字

·會說自己的姓名，地址，年齡和生日

·繪圖趨于現(xiàn)實生活，比如，畫的人有眼睛、嘴和鼻子，身體，胳膊和腿

·會自己閱讀繪本

·了解規(guī)則的重要性，以及規(guī)則背后的簡單的原因。

如何促進五歲到六歲兒童發(fā)育？

1.鼓勵多運動：鼓勵孩子多做一些不同的運動和娛樂活動項目。通過這些活動能讓孩子教會孩子社交的技能，諸如大家輪流來、合作、談判、公平比賽并成為一個有風度的人。

2.讓孩子參與做一些簡單的家務：吃飯時擺桌子或幫助大人收拾干凈的衣服可以培養(yǎng)孩子的活動協(xié)調能力和思維能力，同時也可以培養(yǎng)孩子的合作意識和責任感。這些技能對今后在學校的學習很重要。

3.給孩子留出自由玩耍的時間：即使你的孩子已經(jīng)準備上學了，玩耍在這個年齡階段仍然非常重要。可以考慮讓你的孩子自己選擇和決定在這段自由的游戲時間玩些什么。

4.每天和孩子玩一玩，哪怕只是10分鐘的時間：和孩子一起玩耍讓你有機會進入孩子的世界，了解他們的想法和感受。同時這也能讓你的孩子看到你關心他們，想和他們在一起。

5.和孩子談論感受：你可以幫助你的孩子找出他們?yōu)槭裁磿星榫w和感受，并幫助他們用語言表達出來這些感覺。這將幫助孩子建立友誼并表現(xiàn)出同理心。同時可以和與孩子開始討論平等對待男孩和女孩，尊重女孩和婦女。

6.練習課堂行為：例如，你可以給孩子一些需要集中注意力或者是遵循簡單的規(guī)則或指示的小任務。就孩子最喜歡的動物或運動進行對話，鼓勵孩子傾聽、回答和提問。這些都是幼小銜接的一部分，有助于孩子為上學做好準備。

在什么情況下需要引起重視去看醫(yī)生

如果觀察到五到六歲的孩子有任何一項下述情況的，需要帶孩子去就醫(yī)進一步評估。

? 很難理解或說整個句子

? 很難遵循簡單的指示，如“穿上衣服后請把睡衣放在床上”。

? 有許多不恰當或具有挑戰(zhàn)性的行為——例如，每當他們不能隨心所欲時就會發(fā)脾氣

? 對字母，文字或試圖寫自己的名字不感興趣

? 與你分開時，會表現(xiàn)出非常孤僻沉默寡言、焦慮、或非常沮喪

? 與他人互動和交往不好-例如，表現(xiàn)出攻擊性，或對與其他兒童或成年人互動不感興趣

? 白天仍然會尿濕或大便在褲子上，不過在6-7歲之前，夜間尿床還是常見的，特別是男孩

? 夜間難以入睡或睡不安穩(wěn)

Child development at 5-6 years: what’s happening

Playing and learning

Even as children get older and start school, play is important. It’s still how children learn and build social, emotional and thinking skills.

Your child’s pretend play is more complex now, filled with lots of fantasy and drama. You might also notice that your child can play with others to achieve a common goal – for example, working together to build one big sandcastle. Your child might also be able to work things out if another child doesn’t want to play a particular game. Your child is becoming more social and prefers to play with friends rather than on their own. Your child can share, although they might find it hard to share favourite toys and other things.

Games with rules sometimes challenge your six-year-old, and your child might even accuse others of cheating sometimes.

Feelings

At this age, children can express feelings, although they might need help and time to identify and talk about tricky emotions like frustration or jealousy. They often have much better control over feelings too and might have fewer unexpected outbursts of anger and sadness.

You might see more patience, and your child might even be open to reasoning with you. This means there could be fewer disagreements in the future.Although your six-year-old loves to be independent, they still need your love and attention. Connecting with you and family is the most important thing in your child’s life. Your child is proud of their own achievements, wants your approval – and probably doesn’t take well to criticism or discipline.

Your child’s growing understanding of the world around might lead to some fears. For example, some children might be afraid of supernatural things (like ghosts), criticism, tests, failure, or physical harm or threat.

Thinking

At this age, children can pay attention for longer now.Your child understands simple concepts like time (today, tomorrow, yesterday), knows the seasons, recognises some words by sight and tries to sound out words. Your child might even read on their own.Your child is better at seeing other people’s points of view, which helps your child to make friends and meet new people.

Talking and communicating

At this age children talk a lot, sometimes even when nobody is in the room.

You’ll hear your child using full and complex sentences and having adult-like conversations, although they might still find it hard to describe complex ideas or events. Your child understands jokes and riddles – jokes about poos and wees are particularly funny. Your child also enjoys the opportunity to do ‘show and tell’ at school.

Your child understands more words than they can say, and they’re learning as many as 5-10 new words each day. Vocabulary growth is so rapid at this age that your child’s brain often thinks faster than your child can speak.

Moving

Five-year-olds are more coordinated and love to show off new physical skills – you’ll often hear shouts of ‘Look at me!’ Your child can learn how to ride a bike, jump rope, balance on one foot for a short period of time, walk downstairs without needing to hold your hand, skip and catch a large ball. Many six-year-olds will also be interested in playing team sports like soccer.

Does it seem like your six-year-old can’t ever keep still? Wriggling while watching TV, at the dinner table or even while sleeping is pretty normal.

Your child’s fine motor skills are improving, which leads to more independence with things like tying shoelaces, using chopsticks, zips and buttons, and brushing hair.

At this age, your child might also:

· copy simple shapes with a pencil

· copy letters and write their own name

· say their full name, address, age and birthday

· draw more realistic pictures – for example, a person with a head with eyes, mouth and nose, and a body with arms and legs

· read simple picture books

· understand the importance of rules, and the simple reasons behind rules.

How to help your preschooler development at this age

Encourage moving: play different sports and do recreational activities together or with others. These teach social skills like taking turns, cooperating, negotiating, playing fairly and being a good sport.

Include your child in simple household chores: setting the table or helping you to put clean clothes away develops moving and thinking skills, while also teaching cooperation and responsibility. These skills are important for school.

Set aside some time for free play: even if your child has started school and other structured activities, play is still very important at this age. Let your child choose how to spend this free playtime.

Play with your child each day, even if it’s just for 10 minutes. Playing together gives you the chance to enter your child’s world and find out about their thoughts and feelings. It also shows your child that you care about them and want to spend time together.

Talk about feelings: you can help your child work out why they’re feeling something and help them put words to these feelings. This will help your child form friendships and show empathy. Talk with your child about treating boys and girls equally and respecting girls and women.

Practise classroom behaviour: for example, you could give your child small tasks that need attention or involve following simple rules or instructions. Have conversations about your child’s favourite animal or sport and encourage your child to listen, respond and question. This all helps your child get ready for school.

When to be concerned about child development at 5-6 years

· is difficult to understand or isn’t speaking in full sentences

· has trouble following simple directions like ‘Please put your pyjamas on your bed after you’ve put your clothes on’.

· uses lots of inappropriate or challenging behaviour – for example, has a tantrum whenever they don’t get their own way

· shows no interest in letters or trying to write their own name

· is very withdrawn, worried or depressed or gets very upset when separating from you

· doesn’t interact well with others – for example, is aggressive or shows no interest in interacting with other children or adults

· still wets or soils their pants during the day, but note that night-time wetting is typical up until the age of 6-7 years, especially for boys

· has difficulty falling asleep at night or staying asleep.

作者：澳大利亞墨爾本大學醫(yī)學院兒科博士

百匯醫(yī)療（中國）兒科醫(yī)師