Preschool Children (Ages 2 to 4 Years) - NCS Dietary Assessment Literature Review

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The preschool years are characterized as a time of increasing autonomy, expanding language skills, increasing ability to control behavior, and broadening social circumstances, such as attending preschool or staying with friends or relatives (100). Preschool children continue to expand their gross and fine motor capabilities and by age 4 years, a child can hop, jump on one foot, ride a tricycle or bicycle with training wheels, and throw a ball overhand. Most children consume the foods eaten by the rest of the family by age 2 to 3 years. Feeding is not as messy because the child can use a fork, spoon, and cup well, although the ability to use a knife to cut or spread foods is not fully developed. The overall rate of growth continues to be relatively slow, with periods of growth "spurts." Consequently, the preschool child has a relatively small appetite with periods of increasing food intake in advance of a growth spurt. Although the preschool child's intake may fluctuate widely from meal to meal and day to day, over a week's time the intake remains relatively stable because preschool children have the ability to self-regulate food intake and to adjust their caloric intake to meet caloric needs (133). The child's increasing autonomy and expression of food preferences, combined with a variable appetite, cause many parents to describe their child as a "picky eater" (100).

Many factors make assessing intake in this age group difficult: preschool children eat small amounts of food at frequent intervals; they are not able to complete questionnaires on their own and have a limited cognitive ability to recall, estimate, and otherwise cooperate; they often spend time under the care of several individuals; and their food habits and nutrient intakes may change rapidly (134-136).